Ruiz, Dominador Padua
Ruiz, Dominador Padua is an sole proprietor health care provider with primary practice located at 3412 W Fullerton Ave , Chicago IL 60647-2416. He recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Ambulatory Surgical, Ambulatory Health Care Facilities / Medical Specialty. Ambulatory Health Care Facilities / Medical Specialty is his primary health care specialty. Ruiz, Dominador Padua can be contacted via phone (773) 235-8000.Contact Information
Primary practice address
3412 W Fullerton Ave
Chicago IL 60647-2416
Phone: (773) 235-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | 036-059474 | Illinois |
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | 036-059474 | Illinois |
Profile Details
| NPI number | 1861524407 |
|---|---|
| LBN Legal business name | Ruiz, Dominador Padua |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 9th, 2007 |
| Last updated | Nov 19th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861524407 | NPPES |
| Illinois | Other | 1638831 | BCBS GROUP |
| Illinois | MEDICAID | 036059474 2 | BCBS GROUP |
| Illinois | Other | 1635693 | BCBS GROUP |
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