Individual provider Active NPI

Hector A. Ruiz, C.S.A.

  • Surgical Physician Assistant
  • Chicago, IL
National Provider Identifier
1417131632
Registry record updated Dec 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
03-177 Issued in IL
Practice address
4211 N Cicero Ave
4TH Floor
Chicago, IL 60641-1651
Phone
(773) 545-6900
Fax
(773) 545-2220
NPI assigned
Dec 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 03-177 IL Primary

Addresses

Primary practice location

4211 N Cicero Ave
4TH Floor
Chicago, IL 60641-1651

Mailing address

4211 N Cicero Ave
4TH Floor
Chicago, IL 60641-1651
Phone (773) 545-6900

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

State licenses

LicenseStateTypeSpecialty
03-177ILMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198454400000",
    "number": "1417131632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 N CICERO AVE",
            "address_2": "4TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411651",
            "telephone_number": "773-545-6900",
            "fax_number": "773-545-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 N CICERO AVE",
            "address_2": "4TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411651",
            "telephone_number": "773-545-6900",
            "fax_number": "773-545-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "HECTOR",
        "middle_name": "A.",
        "credential": "C.S.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2007-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "03-177",
            "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 Dec 24, 2007; 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.