Provider Demographics
NPI:1740381169
Name:CUARTAS, ALBERTO DEJESUS (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:DEJESUS
Last Name:CUARTAS
Suffix:
Gender:M
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 3988
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62902-3988
Mailing Address - Country:US
Mailing Address - Phone:618-457-5200
Mailing Address - Fax:618-529-0586
Practice Address - Street 1:3008 CIVIC CIRCLE BLVD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5262
Practice Address - Country:US
Practice Address - Phone:618-993-1030
Practice Address - Fax:618-351-4009
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.098622207RX0202X
IL036-098622207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL10027291OtherBC/BS OF ILLINOIS
IL036098622Medicaid
WI622690Medicare PIN
G76121Medicare UPIN
IL10027291OtherBC/BS OF ILLINOIS
IL214881Medicare Oscar/Certification