Organization Active NPI

Helene M. Ruiz-Pla MD SC

  • Internal Medicine Physician
  • Melrose Park, IL
National Provider Identifier
1285986372
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036079717 Issued in IL
Legal business name
HELENE M. RUIZ-PLA MD SC
Practice address
1835 Broadway St
Suite 103
Melrose Park, IL 60160-2040
Phone
(708) 345-5272
Fax
(708) 345-5282
NPI assigned
Oct 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Helene Marie Ruiz-Pla, M.D.NPI 1922171750
Title
President
Phone
(708) 345-5272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036079717 IL Primary

Addresses

Primary practice location

1835 Broadway St
Suite 103
Melrose Park, IL 60160-2040

Mailing address

1835 Broadway St
Suite 103
Melrose Park, IL 60160-2040
Phone (708) 345-5272

Other identifiers 2

IdentifierTypeStateIssuer
1922171750OtherILNPI
20013434MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130501000431 IL Part B Supplier - Clinic/Group Practice 0648417121 Receives reassigned benefits from 1 practitioner
Practice locations: Melrose Park, IL

National Provider Directory

National Provider Directory
Tax ID family
Helene M Ruiz-Pla MD SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1835 N 19th Ave
Ste 103
Melrose Park, IL 60160
Phone (708) 345-5272

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1285986372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 BROADWAY ST",
            "address_2": "SUITE 103",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601602040",
            "telephone_number": "708-345-5272",
            "fax_number": "708-345-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 BROADWAY ST",
            "address_2": "SUITE 103",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601602040",
            "telephone_number": "708-345-5272",
            "fax_number": "708-345-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELENE M. RUIZ-PLA MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "RUIZ-PLA",
        "authorized_official_first_name": "HELENE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-345-5272",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036079717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1922171750",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20013434",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.