Provider Demographics
NPI:1790946929
Name:RDI VEIN LLC
Entity Type:Organization
Organization Name:RDI VEIN LLC
Other - Org Name:BELLA VEIN INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALDO
Authorized Official - Middle Name:C
Authorized Official - Last Name:RUFFOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:217-355-8346
Mailing Address - Street 1:2502 GALEN DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-7049
Mailing Address - Country:US
Mailing Address - Phone:217-355-8346
Mailing Address - Fax:217-355-8347
Practice Address - Street 1:2502 GALEN DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821
Practice Address - Country:US
Practice Address - Phone:217-355-8346
Practice Address - Fax:217-355-8347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology