Individual provider Active NPI

Paul Ruestow, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Chicago, IL
National Provider Identifier
1700896065
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036-055870 Issued in IL
Practice address
2545 S King Dr
Chicago, IL 60616-2441
Phone
(312) 842-7117
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036-055870 IL Primary

Addresses

Primary practice location

2545 S King Dr
Chicago, IL 60616-2441

Mailing address

2311 W 22ND St
Suite 202
Oak Brook, IL 60523-1225

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pruestow206347@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101119000189 IL Practitioner - Internal MedicinePractitioner - Geriatric MedicinePractitioner - Endocrinology 8426244260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-055870ILMDEndocrinology, Diabetes & Metabolism Physician

Interoperability endpoints

  • Direct secure messaging: pruestow206347@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1700896065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 W 22ND ST",
            "address_2": "SUITE 202",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162441",
            "telephone_number": "312-842-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUESTOW",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036-055870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pruestow206347@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2545 S King Dr",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606162441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2545 S King Dr",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606162441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.