Provider Demographics
NPI:1578969267
Name:RUEGER, SANDRA YU (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:YU
Last Name:RUEGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 MAYFAIR LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-2743
Mailing Address - Country:US
Mailing Address - Phone:847-710-6244
Mailing Address - Fax:
Practice Address - Street 1:1497 N LA FOX ST
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-1227
Practice Address - Country:US
Practice Address - Phone:847-710-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008856103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical