Individual provider Active NPI

Andrew D. Ruthberg, MD

  • Rheumatology Physician
  • Chicago, IL
National Provider Identifier
1174629836
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036.121932 Issued in IL
Practice address
1725 W Harrison St
Suite 1017
Chicago, IL 60612-3841
Phone
(312) 942-6641
Fax
(312) 563-2075
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 49505 WI
Rheumatology Physician 207RR0500X 036.121932 IL Primary

Addresses

Primary practice location

1725 W Harrison St
Suite 1017
Chicago, IL 60612-3841

Mailing address

1725 W Harrison St
Suite 1017
Chicago, IL 60612-3841
Phone (312) 942-6641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081212000588 IL Practitioner - RheumatologyPractitioner - Internal Medicine 8527065655 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.121932ILMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Rush University Medical Group CurrentSince Oct 1, 2020 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1611 W Harrison St
Ste 510
Chicago, IL 60612
Phone (312) 563-2800

1611 W Harrison St
#510
Chicago, IL 60612

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1725 W Harrison St
Ste 1017
Chicago, IL 60612
Phone (312) 563-2800

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Interoperability endpoints

  • Direct secure messaging: aruthberg12144@direct.rush.rush-health.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1174629836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 1017",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-6641",
            "fax_number": "312-563-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 1017",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-6641",
            "fax_number": "312-563-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHBERG",
        "first_name": "ANDREW",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "49505",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036.121932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.