Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 036.124806 | IL |
N | 207N00000X | Dermatologist | 35089650 | OH |
N | 207ND0900X | Dermatopathologist | 036.124806 | IL |
NPI | 1134328511 |
---|---|
Provider Name | Arlene M Ruiz De Luzuriaga |
First Address | Burr Ridge, IL 60527-5965 |
Second Address | Chicago, IL 60637-1447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2007 |
Last Update Date | 17/08/2020 |