Provider Demographics
NPI:1558337303
Name:SONGCO-CHI, RUTH AMOR (DPM)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:AMOR
Last Name:SONGCO-CHI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 LEMONT RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-1510
Mailing Address - Country:US
Mailing Address - Phone:630-218-0014
Mailing Address - Fax:630-218-0017
Practice Address - Street 1:1450 PLAINFIELD RD
Practice Address - Street 2:SUITE 6
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5944
Practice Address - Country:US
Practice Address - Phone:630-218-0014
Practice Address - Fax:630-218-0017
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-005222213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5509750001Medicare NSC
ILK36065Medicare PIN
IL354610Medicare PIN
ILV05224Medicare UPIN