Individual provider Active NPI

Paul Ruzila, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1427145200
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010078 Issued in IL
Practice address
850 S Wabash Ave
Ste 290
Chicago, IL 60605-3641
Phone
(312) 212-1150
Fax
(312) 212-1160
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038010078 IL Primary

Addresses

Primary practice location

850 S Wabash Ave
Ste 290
Chicago, IL 60605-3641

Mailing address

850 S Wabash Ave
Ste 290
Chicago, IL 60605-3641
Phone (312) 212-1150

Other identifiers 1

IdentifierTypeStateIssuer
01634259OtherILBLUE CROSS BLUE SHIELD IL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040717000045 IL Practitioner - Chiropractic 3971582834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 E Wisconsin Ave
Suite 15
Lake Forest, IL 60045-1701
Phone (312) 212-1150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038010078ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Ruzila D.C. LTD. Chiropractor CurrentSince May 1, 2004 Accepting new patients

Locations

850 S Wabash Ave
Ste 290
Chicago, IL 60605
Phone (312) 212-1150

222 E Wisconsin Ave
Ste 15
Lake Forest, IL 60045
Phone (312) 212-1150

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331856000000",
    "number": "1427145200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S WABASH AVE",
            "address_2": "STE 290",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053641",
            "telephone_number": "312-212-1150",
            "fax_number": "312-212-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S WABASH AVE",
            "address_2": "STE 290",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053641",
            "telephone_number": "312-212-1150",
            "fax_number": "312-212-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZILA",
        "first_name": "PAUL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "01634259",
            "state": "IL"
        }
    ],
    "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 Mar 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.