Rusin, Edward Baxter

Rusin, Edward Baxter is an individual health care provider with primary practice located at 7009 Crystal Springs Road , Crystal Lake IL 60012-1154. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Rusin, Edward Baxter can be contacted via phone (815) 455-7333.

Contact Information

Primary practice address
7009 Crystal Springs Road Crystal Lake IL 60012-1154
Phone: (815) 455-7333
Fax: (815) 477-0821
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1235278342
LBN Legal business name Rusin, Edward Baxter
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jul 8th, 2007 - about 18 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 1235278342 NPPES
Illinois Other 5672007 BC BS

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