Provider Demographics
NPI:1437787439
Name:RUH, MITCH
Entity Type:Individual
Prefix:
First Name:MITCH
Middle Name:
Last Name:RUH
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 1:5S230 SWAN RD
Mailing Address - Street 2:
Mailing Address - City:BIG ROCK
Mailing Address - State:IL
Mailing Address - Zip Code:60511-9772
Mailing Address - Country:US
Mailing Address - Phone:630-546-1075
Mailing Address - Fax:
Practice Address - Street 1:5122 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2458
Practice Address - Country:US
Practice Address - Phone:708-499-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist