Bryan Rubach M D SC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BRYAN RUBACH M D SC

Practice address

1256 Waterford Dr
Suite 170
Aurora, IL 60504-4510

Phone

(630) 820-8653

Fax

(630) 820-7238

NPI assigned

Aug 4, 2006

Organization subpart

No

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

Authorized official

Name

Michelle Sabon

Title

Office Manager

Phone

(630) 820-8653

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Midwest ENT Associates S C Other name

Locations

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1306854583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 WATERFORD DR",
            "address_2": "SUITE 170",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044510",
            "telephone_number": "630-820-8653",
            "fax_number": "630-820-7238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 WATERFORD DR",
            "address_2": "SUITE 170",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044510",
            "telephone_number": "630-820-8653",
            "fax_number": "630-820-7238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN RUBACH M D SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "SABON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "630-820-8653"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "040008621",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4506907",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7642444",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest ENT Associates S C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tyler Brown
• Mary Browning
• Tracy Paula Brumund, MA, CCC-SLP/L
• Michele L Bruno, D.D.S.
• Autumn Brush
• Sandell D Bryan
• Autumn Bryant, M.A., CCC-SLP/L
• Emily L Bryant, MS
• Kayla Denice Bryant
• Sa'de Nacole Bryant

• Specialist in Aurora, IL
• Providers in Aurora, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.