Provider Demographics
NPI:1710975511
Name:STRAUSS, RONALD G (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:G
Last Name:STRAUSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5317
Mailing Address - Country:US
Mailing Address - Phone:847-260-2728
Mailing Address - Fax:847-260-2412
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-0387
Practice Address - Fax:319-356-0331
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20321207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA33956OtherWELLMARK BCBS
IAE1131631Medicaid
IA54373OtherWELLMARK BCBS
IA0131631Medicaid
IA54373OtherWELLMARK BCBS
IA33956OtherWELLMARK BCBS
A01164Medicare UPIN
IAP00050295Medicare PIN
IAI9699Medicare PIN