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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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