Provider Demographics
NPI:1114905874
Name:RUFF, BRADLEY E (MD,)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:E
Last Name:RUFF
Suffix:
Gender:M
Credentials:MD,
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Mailing Address - Street 1:900 N WESTMORELAND RD
Mailing Address - Street 2:LL84
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1674
Mailing Address - Country:US
Mailing Address - Phone:847-295-0001
Mailing Address - Fax:847-535-9782
Practice Address - Street 1:900 N WESTMORELAND RD
Practice Address - Street 2:LL84
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1674
Practice Address - Country:US
Practice Address - Phone:847-295-0001
Practice Address - Fax:847-535-9782
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2014-06-05
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Provider Licenses
StateLicense IDTaxonomies
IL036062774207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL624980Medicare ID - Type Unspecified
ILD15514Medicare UPIN