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General NPI Number Information
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NPI Number | 1316450356
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Entity Type | Individual
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Provider Name | SER ADLIN CRUZ
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Gender | Male
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 301 PARTRIDGE LANE
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City | WHEELING
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State | IL
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Zip | 60090-3149
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Country | US
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Telephone | 224-676-8448
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Fax |
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Provider Business Mailing Address
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Address Line | 301 PARTRIDGE LN
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City | WHEELING
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State | IL
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Zip | 60090-3149
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 075242
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05007445A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.022066
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License Number State | IL
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