Samantha Mary Ruhbeck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.006114 Issued in IL

Practice address

370 Larry Power Rd Ste 1
Bourbonnais, IL 60914-5194

Phone

(815) 937-3515

Fax

(815) 935-0916

NPI assigned

Feb 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Abc Pediatrics of Kankakee County

  • Pediatrics Physician
  • Bourbonnais, IL
  • NPI 1831205194
  NPD (past)

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1396284949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LARRY POWER RD STE 1",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145194",
            "telephone_number": "815-937-3515",
            "fax_number": "815-935-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 LARRY POWER RD STE 1",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145194",
            "telephone_number": "815-937-3515",
            "fax_number": "815-935-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUHBECK",
        "first_name": "SAMANTHA",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camela Rosenthal
• Shavez Rosenthal
• Rebecca Routson
• Amanda J Roy
• Nicole Roy, LPC
• Nicholas J Rutkowski, O.D.
• Bernard Eugene Ryan II, D.D.S.
• Kathleen M Saindon II
• Giovanni M Salerno, MD
• Chloe Ann Sanford

• Physician Assistant in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.