Provider Demographics
NPI:1326204462
Name:ALARCON, RUBEN E
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:E
Last Name:ALARCON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W CHICAGO AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 W CHICAGO AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3355
Practice Address - Country:US
Practice Address - Phone:630-323-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.022644122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist