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Dr. Dominador Padua Ruiz, MD
Medical Specialty Clinic/Center in Chicago, Illinois
NPI 1861524407

Dominador Padua Ruiz is a Medical Specialty Clinic/Center based in Lincolnwood, IL and is specialized in Medical Specialty. Dominador Padua Ruiz practices in Chicago, IL and has the professional credentials of MD. The NPI Number for Dominador Padua Ruiz is 1861524407 and holds a License No. 036-059474 (Illinois).

The current practice location address for Dominador Padua Ruiz is 3412 W Fullerton Ave, Chicago, IL and can be reached out via phone at 773-235-8000. You can also correspond with Dominador Padua Ruiz through the mailing address at 3950 W JARLATH ST, LINCOLNWOOD, IL - 60712-1018 (mailing address contact number: 847-982-9166).

Location: 3412 W Fullerton Ave, Chicago, IL, 60712-1018
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Provider Profile Details
NPI Number
1861524407
Provider Name
Dominador Padua Ruiz
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3412 W Fullerton Ave, Chicago, IL, 60712-1018
Phone Number
773-235-8000
Fax Number
Provider Enumeration Date
03/09/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1638831 01 IL BCBS GROUP
036059474 2 05 IL
1635693 01 IL BCBS
institution
Provider Business Practice Location Address Details
Address
3412 W Fullerton Ave
City
State
Zip
60647-2416
Phone Number
773-235-8000
Fax Number
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Provider Business Mailing Address Details
Address
3412 W Fullerton Ave
City
State
Zip
60647-2416
Phone Number
773-235-8000
Fax Number
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Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
License No.
036-059474 (Illinois)
Definition
Definition to come...
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Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
License No.
036-059474 (Illinois)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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