Provider Demographics
NPI:1578679627
Name:ODEH, RUBA (DO)
Entity Type:Individual
Prefix:DR
First Name:RUBA
Middle Name:
Last Name:ODEH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7900 N MILWAUKEE AVE STE 231A
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3247
Mailing Address - Country:US
Mailing Address - Phone:847-663-9400
Mailing Address - Fax:847-663-9827
Practice Address - Street 1:7900 N MILWAUKEE AVE
Practice Address - Street 2:SUITE 231
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3159
Practice Address - Country:US
Practice Address - Phone:847-663-9400
Practice Address - Fax:847-663-9827
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-096009207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease