Healthcare Provider Details

I. General information

NPI: 1215257522
Provider Name (Legal Business Name): CHRISTINA CRUZ CEDENO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 09/11/2025
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2418 W DIVISION ST ERIE FAMILY HEALTH CENTER
CHICAGO IL
60622-2940
US

IV. Provider business mailing address

2418 W DIVISION ST ERIE FAMILY HEALTH CENTER
CHICAGO IL
60622-2940
US

V. Phone/Fax

Practice location:
  • Phone: 312-666-3494
  • Fax:
Mailing address:
  • Phone: 312-666-3494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.135072
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: