Healthcare Provider Details

I. General information

NPI: 1457344194
Provider Name (Legal Business Name): HUGO F CUADROS MD,FACC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10837 S CICERO AVE STE 200
OAK LAWN IL
60453-6459
US

IV. Provider business mailing address

10837 S CICERO AVE STE 200
OAK LAWN IL
60453-6459
US

V. Phone/Fax

Practice location:
  • Phone: 708-636-7575
  • Fax: 708-636-6193
Mailing address:
  • Phone: 708-636-7575
  • Fax: 708-636-6193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036-042050
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: