PAUL J CRUZ NPI 1619956935

NPI Information

NPI: 1619956935
Provider Name: PAUL J CRUZ
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual
Address:
3303 LOGAN DR
REA CLINIC HERRIN
HERRIN, IL
ZIP 62948
Phone: (618) 993-5767
Get Directions

Paul J Cruz is an obstetrics gynecology in Herrin, IL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Paul J Cruz NPI is 1619956935. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3303 LOGAN DR
REA CLINIC HERRIN
HERRIN, IL
ZIP 62948
Phone: (618) 993-5767
Fax: (618) 724-2571

The enumeration date for this NPI number is 1/13/2006 and was last updated on 10/22/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207V00000X	Obstetrics & Gynecology		036077364	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	175114	OTHER	ILLINOIS	HEALTHLINK
2	K03111	MEDICARE ID-TYPE UNSPECIFIED
3	036077364	MEDICAID	ILLINOIS
4	027163	OTHER	ILLINOIS	HEALTH ALLIANCE
5	D89412	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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