Rukvidtayasas, Santi

Rukvidtayasas, Santi is an individual health care provider with primary practice located at 7047 North Ave , Oak Park IL 60302-1015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Rukvidtayasas, Santi can be contacted via phone (708) 383-0300.

Contact Information

Primary practice address
7047 North Ave Oak Park IL 60302-1015
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036-050639 Illinois

Profile Details

NPI number 1538297874
LBN Legal business name Rukvidtayasas, Santi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2007
Last updated Jul 8th, 2007 - about 17 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 1538297874 NPPES
Illinois Other 01615155 BLUE CROSS BLUE SHIELD

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