Logan Square Medical Institute SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LOGAN SQUARE MEDICAL INSTITUTE SC

Practice address

3061 W. Logan Blvd
Chicago, IL 60647-1707

Phone

(773) 772-7899

Fax

(773) 772-7896

NPI assigned

Mar 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gonzalo Ruiz, M.D.

Title

Physician

Phone

(773) 772-7899

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emilia Ruiz, M.D.

  • Internal Medicine Physician
  • Madison, WI
  • NPI 1497048235
  NPD

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1447559000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 W. LOGAN BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60647",
            "telephone_number": "773-772-7899",
            "fax_number": "773-772-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 W. LOGAN BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471707",
            "telephone_number": "773-772-7899",
            "fax_number": "773-772-7896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN SQUARE MEDICAL INSTITUTE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "773-772-7899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Square Anesthesia PC
• Logan Square Counseling LLC
• Logan Square Dental Service Center
• Logan Square Foot Center
• Logan Square Foot Center PC
• Logan Square MRI
• Logan Square Supportive Living LLC
• Logan Square Surgery Center
• Logan Square Surgery Center Corp
• Logan Square Urgent Care Center Corporation

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.