Provider Demographics
NPI:1629452958
Name:RUZGYS, RASA (CADC)
Entity Type:Individual
Prefix:
First Name:RASA
Middle Name:
Last Name:RUZGYS
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E HAWTHORN PKWY STE 235
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1454
Mailing Address - Country:US
Mailing Address - Phone:478-683-4358
Mailing Address - Fax:857-859-5885
Practice Address - Street 1:16221 W 159TH ST STE 102
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-7902
Practice Address - Country:US
Practice Address - Phone:847-868-3435
Practice Address - Fax:857-859-5885
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
IL178.015479101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)