Gary S Rukin, LPC

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

License

178006202 Issued in IL

Practice address

1301 Pyott Rd Ste 101
Lake in the Hills, IL 60156-9795

Phone

(847) 916-7160

NPI assigned

Dec 21, 2021

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1417617200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 SOMERSET CT",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601021941",
            "telephone_number": "847-650-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PYOTT RD STE 101",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601569795",
            "telephone_number": "847-916-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUKIN",
        "first_name": "GARY",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-21",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "IL",
            "license": "178006202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Group Psychotherapy Psychologist in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• Group Psychotherapy Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.