Provider Demographics
NPI:1083921753
Name:MILEYKOVSKY RUVIN
Entity Type:Organization
Organization Name:MILEYKOVSKY RUVIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILEYKOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-279-8512
Mailing Address - Street 1:620 MACARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-3423
Mailing Address - Country:US
Mailing Address - Phone:847-279-8512
Mailing Address - Fax:
Practice Address - Street 1:620 MACARTHUR DR
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-3423
Practice Address - Country:US
Practice Address - Phone:847-279-8512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5033053347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle