Provider Demographics
NPI:1518908540
Name:VALENTIN, RUTH ROSE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ROSE
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:ROSE
Other - Last Name:VALENTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1860 PAYSPHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0018
Mailing Address - Country:US
Mailing Address - Phone:630-942-7998
Mailing Address - Fax:
Practice Address - Street 1:16660 S 107TH AVE
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467
Practice Address - Country:US
Practice Address - Phone:708-403-8500
Practice Address - Fax:708-364-7080
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9187993363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL050540914OtherTAX-ID
IL4673170001OtherDMERC
IL01633122OtherBCBS
IL$$$$$$$$$Medicaid
ILP00130032/CK6882OtherRAILROAD MEDICARE PIN
IL01633122OtherBCBS