Provider Demographics
NPI:1073529897
Name:RMU NEUROLOGY SC
Entity Type:Organization
Organization Name:RMU NEUROLOGY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODRIGO
Authorized Official - Middle Name:M
Authorized Official - Last Name:UBILUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-964-7136
Mailing Address - Street 1:4121 FAIRVIEW AVE
Mailing Address - Street 2:204
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2264
Mailing Address - Country:US
Mailing Address - Phone:630-964-7136
Mailing Address - Fax:630-353-0765
Practice Address - Street 1:4121 FAIRVIEW AVE
Practice Address - Street 2:204
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2264
Practice Address - Country:US
Practice Address - Phone:630-964-7136
Practice Address - Fax:630-353-0765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360815812084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632454OtherBC/BS PROVIDER #
IL036081581Medicaid
IL204012Medicare PIN