Provider Demographics
NPI:1316030505
Name:RUDER, JOHN R (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:RUDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:515 W ALGONQUIN RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4439
Mailing Address - Country:US
Mailing Address - Phone:847-956-0099
Mailing Address - Fax:847-956-0433
Practice Address - Street 1:515 W ALGONQUIN RD
Practice Address - Street 2:SUITE 120
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4439
Practice Address - Country:US
Practice Address - Phone:847-956-0099
Practice Address - Fax:847-956-0433
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL72192Medicare PIN
ILL23157Medicare PIN
D07845Medicare UPIN