Brian Charles Ruiz, M.D.
Individual provider Active NPI Internal Medicine Physician · East Carondelet, IL
NPI 1821173154 · NPPES record last updated Apr 19, 2011
Key facts
- NPI
- 1821173154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036-068269 (IL)
- Practice address
- 7843 Nevois LN
East Carondelet, IL 62240-1535 - Phone
- (618) 286-4438
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-068269 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Red Bud Illinois Hospital Company, LLC | Past | Accepting new patients | |
| Red Bud Physician Group LLC | Past | Accepting new patients | |
| Waterloo Medical Center PC | Past |
Accepting new patients | |
| Baron Health Service, LLC | Internal Medicine | Past | Accepting new patients |
Interoperability endpoints
- brian.ruiz.1@13162.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-068269 | IL | Yes |
| Internal Medicine Physician | 207R00000X | 2001026972 | MO |
Addresses
Primary practice location
7843 Nevois LN
East Carondelet, IL 62240-1535
Mailing address
7843 Nevois LN
East Carondelet, IL 62240-1535
Phone (618) 286-4438
Other providers in East Carondelet, IL
All providers in East Carondelet, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2011. 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.