Provider Demographics
NPI:1497808174
Name:RUZICH, MARGARET A (SLP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:A
Last Name:RUZICH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22108 PRINCETON CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8503
Mailing Address - Country:US
Mailing Address - Phone:708-717-4924
Mailing Address - Fax:815-464-9196
Practice Address - Street 1:22108 PRINCETON CIR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-8503
Practice Address - Country:US
Practice Address - Phone:708-717-4924
Practice Address - Fax:815-464-9196
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932158OtherBCBS ID NUMBER