Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | IL |
NPI | 1316030505 |
---|---|
Provider Name | John R Ruder |
First Address | Arlington Heights, IL 60005-4439 |
Second Address | Arlington Heights, IL 60005-4439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 03/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D07845 | (02) |