Provider Demographics
NPI:1083788335
Name:RUBIN, FRANK E (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:E
Last Name:RUBIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 ENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2222
Mailing Address - Country:US
Mailing Address - Phone:847-475-3937
Mailing Address - Fax:847-475-9572
Practice Address - Street 1:1962 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1016
Practice Address - Country:US
Practice Address - Phone:847-475-3937
Practice Address - Fax:847-475-9572
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046007781152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046007781Medicaid
IL0001632664OtherBLUE CROSS BLUE SHIELD
IL0282210001OtherDMERC
IL747670Medicare ID - Type Unspecified
IL046007781Medicaid