NPIMap

Organization Active NPI

The Ruth Institute of Integrative Care LLC

  • Psychiatry Physician
  • Northbrook, IL
National Provider Identifier
1538745153
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
THE RUTH INSTITUTE OF INTEGRATIVE CARE LLC
Practice address
5 Revere Dr Ste 200
Northbrook, IL 60062-8000
Phone
(917) 475-6181
NPI assigned
Mar 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Dr. Diego MarinNPI 1750818746
Title
Owner
Phone
(917) 475-6181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5 Revere Dr Ste 200
Northbrook, IL 60062-8000

Mailing address

5 Revere Dr Ste 200
Northbrook, IL 60062-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210525002542 IL Part B Supplier - Clinic/Group Practice 1153720008 Receives reassigned benefits from 7 practitioners
Practice locations: Chicago, IL; Evanston, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1538745153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 200",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 200",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628000",
            "telephone_number": "917-475-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RUTH INSTITUTE OF INTEGRATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "MARIN",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-475-6181",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.