Edward Baxter Rusin, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Practice address

7009 Crystal Springs Road
Crystal Lake, IL 60012-1154

Phone

(815) 455-7333

Fax

(815) 477-0821

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235278342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7009 CRYSTAL SPRINGS ROAD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600121154",
            "telephone_number": "815-455-7333",
            "fax_number": "815-477-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7009 CRYSTAL SPRINGS ROAD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600121154",
            "telephone_number": "815-455-7333",
            "fax_number": "815-477-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSIN",
        "first_name": "EDWARD",
        "middle_name": "BAXTER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "5672007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Louis Rubin, R.PH. AE-C
• Mandy J Rueff, APRN
• Allison Ruscheinski
• Steven P Ruscheinski, LCSW
• Rush-Select Holdings, LLC.
• Janet A Rutherford, P.T.
• Ryan Counseling Services Inc.
• Ashley Ryan, D.C.
• Casey C Ryan, MSW, LSW
• Erin Ryan, MSOM, LAC

• Clinical Psychologist in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.