Individual ProviderRalph Dela CruzNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address609 Jon Ln, Des Plaines, IL 60016-1003(224) 402-3175(708) 354-2550PECOS EnrollmentBased on the most recent information from CMS, provider Ralph Dela Cruz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1972223964Provider TypeIndividualFull NameDela Cruz, RalphGenderMaleSole ProprietorYesEnumeration Date8/30/2022Last Updated10/8/2024Contact InformationPractice LocationPractice Address609 Jon Ln, Des Plaines, IL 60016-1003Phone(224) 402-3175FaxUnlisted FaxMailing LocationMailing Address5201 Willow Springs Rd Ste 380, La Grange Highlands, IL 60525-6539Phone(708) 354-2550FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense209.025854Illinois