Provider Demographics
NPI:1184847287
Name:MONTEROLA, FE CRUZ (MD)
Entity Type:Individual
Prefix:MRS
First Name:FE
Middle Name:CRUZ
Last Name:MONTEROLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6630
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-6630
Mailing Address - Country:US
Mailing Address - Phone:630-240-2981
Mailing Address - Fax:
Practice Address - Street 1:5645 WEST ADDISON STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4403
Practice Address - Country:US
Practice Address - Phone:773-282-7000
Practice Address - Fax:773-794-4681
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AM8968224OtherDEA
AM8968224OtherDEA