Mr. Robert E Ruderman
Adolescent Medicine
1160 Park Avenue West
Highland Park
, Illinois 60035
Mr. Robert E Ruderman
Adolescent Medicine
1160 Park Avenue West
Highland Park
, Illinois 60035
(847) 432-9480
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Mr. Robert E Ruderman
- 900 North Westmoreland Road #217
- Lake Forest, IL
- Zip : 60045
- Fax : (847) 432-9480
- Phone : (847) 432-8422
Second Address
- Mr. Robert E Ruderman
- 1160 Park Avenue West
- Highland Park, IL
- Zip : 60035
- Fax : (847) 432-9480
- Phone : (847) 432-8422
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 036-053789 | IL |
National Provider Identifier
| NPI | 1093740730 |
|---|---|
| Provider Name | Mr. Robert E Ruderman |
| First Address | Lake Forest, IL 60045 |
| Second Address | Highland Park, IL 60035 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/07/2006 |
| Last Update Date | 24/01/2013 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.