MEDICARE: ORLANDO CRUZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	125049711	IL

General Provider Information

NPI Number	:	1316103013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ORLANDO CRUZ M.D.

Provider Business Mailing Address
First Line	:	1901 WEST POLK ST.
Second Line	:	10TH FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60612
Country	:	US
Telephone Number	:	312-864-0064
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 WEST POLK ST.
Second Line	:	SUITE 1051
City	:	CHICAGO
State	:	IL
Zip	:	60612
Country	:	US
Telephone Number	:	312-864-0064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	08/01/2008

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