Individual provider Active NPI

Ruth Ceulemans, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1730140062
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301065290 Issued in MI
Practice address
5841 S Maryland Ave # Mc2026
Chicago, IL 60637
Phone
(773) 702-1061
NPI assigned
Mar 28, 2006
Last updated
Nov 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036107850 IL
Diagnostic Radiology Physician 2085R0202X 62774 WI
Diagnostic Radiology Physician 2085R0202X 4301065290 MI Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc2026
Chicago, IL 60637

Mailing address

150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965
Phone (773) 702-1000

Other practice location 1

20509 Northville Place Dr
Unit 2019
Northville, MI 48167-2993
Phone (248) 921-2459

Other practice location 2

20509 Northville Place Dr
Unit 2019
Northville, MI 48167-2993
Phone (248) 921-2459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036107850ILMDDiagnostic Radiology Physician
4301065290MIMDDiagnostic Radiology Physician
62774WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Diagnostic Radiology CurrentSince Nov 3, 2015 Accepting new patients
Basha Diagnostics P C Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
Henry Ford Health System CurrentSince Nov 3, 2015 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-4316

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

30701 Woodward Ave
Ste Ll
Royal Oak, MI 48073
Phone (248) 288-1600

Interoperability endpoints

  • Direct secure messaging: rceulemans593441@direct.emplifyhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1730140062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965",
            "telephone_number": "773-702-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC2026",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-1061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20509 Northville Place Dr",
            "address_2": "Unit 2019",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481672993",
            "country_code": "US",
            "telephone_number": "248-921-2459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20509 Northville Place Dr",
            "address_2": "Unit 2019",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481672993",
            "country_code": "US",
            "telephone_number": "248-921-2459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEULEMANS",
        "first_name": "RUTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036107850",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "62774",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301065290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.