Provider Demographics
NPI:1235196635
Name:PAPA, RUKSANA (MD)
Entity Type:Individual
Prefix:DR
First Name:RUKSANA
Middle Name:
Last Name:PAPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 W CENTRAL RD STE 40
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2477
Mailing Address - Country:US
Mailing Address - Phone:847-392-5723
Mailing Address - Fax:
Practice Address - Street 1:1700 W CENTRAL RD STE 40
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2477
Practice Address - Country:US
Practice Address - Phone:847-392-5723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036105541207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036105541Medicaid
IL036105541Medicaid
ILH52290Medicare UPIN