Shirley Diane Ruck, APN, ANP-BC
Individual provider Active NPI Adult Health Nurse Practitioner · Hinsdale, IL
NPI 1437496643 · NPPES record last updated Jan 24, 2013
Key facts
- NPI
- 1437496643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 209.010142 (IL)
- Practice address
- 111 E. Odgen Ave. Suite 111
Hinsdale, IL 60521-3590 - Phone
- (630) 856-6990
- Fax
- (630) 856-6999
- NPI assigned
- Jan 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.010142 | IL | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Midwest Health | Past | Accepting new patients | |
| Adventist Midwest Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 209.010142 | IL | Yes |
Addresses
Primary practice location
111 E. Odgen Ave. Suite 111
Hinsdale, IL 60521-3590
Mailing address
119 E Ogden Ave Ste 111
Hinsdale, IL 60521-8654
Phone (630) 856-6990
Other providers in Hinsdale, IL
- Erlo Roth
- Fred Rothenberger
- RT Foot and Ankle Specialists, LLC
- Ruben E. Alarcon DDS, LTD.
- Brynna Vigee-Clary Rubin
- Ashley Brett Rudnick
- Allison Rule
- Rush-Select Holdings, LLC.
- Aubri Ann Rush
- Karen S Russell
All providers in Hinsdale, IL · Adult Health Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.