Individual provider Active NPI

Edgar Franklin Ruble Jr., D.C.

  • Chiropractor
  • Schaumburg, IL
National Provider Identifier
1063408680
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-004483 Issued in IL
Practice address
1756 W Wise Rd
Schaumburg, IL 60193-3524
Phone
(847) 534-0290
Fax
(847) 534-0292
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-004483 IL Primary

Addresses

Primary practice location

1756 W Wise Rd
Schaumburg, IL 60193-3524

Mailing address

1756 W Wise Rd
Schaumburg, IL 60193-3524
Phone (847) 534-0290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121110000137 IL Practitioner - Chiropractic 6204087745 Practice locations: Schaumburg, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

175 W Wise Rd
Schaumburg, IL 60193-3524

1756 W Wise Rd
Schaumburg, IL 60193-3524
Phone (847) 534-0290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-004483ILMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1063408680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 W WISE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933524",
            "telephone_number": "847-534-0290",
            "fax_number": "847-534-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 W WISE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933524",
            "telephone_number": "847-534-0290",
            "fax_number": "847-534-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBLE",
        "first_name": "EDGAR",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-004483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.