Active NPI
Amanda Dawn Rueach, M.ED, ATC
- Athletic Trainer
- Chicago, IL
National Provider Identifier
1235400201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.002630
- Practice address
- 305 West Wacker Drive
Suite 1020
Chicago, IL 60606 - Phone
- (312) 640-0329
- NPI assigned
- Jan 23, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.002630 | WI | Primary |
Addresses
Primary practice location
305 West Wacker Drive
Suite 1020
Chicago, IL 60606
Mailing address
3100 Elim Ave
Zion, IL 60099-3214
Phone (847) 246-7464
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.002630 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327276800000",
"number": "1235400201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 ELIM AVE",
"city": "ZION",
"state": "IL",
"postal_code": "600993214",
"telephone_number": "847-246-7464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 WEST WACKER DRIVE",
"address_2": "SUITE 1020",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60606",
"telephone_number": "312-640-0329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUEACH",
"first_name": "AMANDA",
"middle_name": "DAWN",
"credential": "M.ED, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-23",
"last_updated": "2012-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "096.002630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.