Provider Demographics
NPI:1659654887
Name:RUELES, JEHU RUELO
Entity Type:Individual
Prefix:MR
First Name:JEHU
Middle Name:RUELO
Last Name:RUELES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22W129 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MEDINAH
Mailing Address - State:IL
Mailing Address - Zip Code:60157-9528
Mailing Address - Country:US
Mailing Address - Phone:847-744-5978
Mailing Address - Fax:847-744-5978
Practice Address - Street 1:22W129 WOODVIEW DR
Practice Address - Street 2:
Practice Address - City:MEDINAH
Practice Address - State:IL
Practice Address - Zip Code:60157-9528
Practice Address - Country:US
Practice Address - Phone:847-744-5978
Practice Address - Fax:847-744-5978
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018757174400000X, 225100000X
2251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics