Provider Demographics
NPI:1558502872
Name:RUBIN, JULIE MARLANE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARLANE
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:MARLANE
Other - Last Name:ALBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6768 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5298
Mailing Address - Country:US
Mailing Address - Phone:630-455-1855
Mailing Address - Fax:
Practice Address - Street 1:6768 FIELDSTONE DR
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-5298
Practice Address - Country:US
Practice Address - Phone:630-455-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036091029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine