Provider Demographics
NPI:1114280427
Name:RUBIN, JASON SETH (DPM)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:SETH
Last Name:RUBIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1020 E OGDEN AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8610
Mailing Address - Country:US
Mailing Address - Phone:630-780-3668
Mailing Address - Fax:630-839-4050
Practice Address - Street 1:1020 E OGDEN AVE STE 214
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8610
Practice Address - Country:US
Practice Address - Phone:630-780-3668
Practice Address - Fax:630-839-4050
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005582213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery