Provider Demographics
NPI:1881041663
Name:RUIZ, ERIKA VANESSA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:VANESSA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1611
Mailing Address - Country:US
Mailing Address - Phone:708-547-8736
Mailing Address - Fax:
Practice Address - Street 1:806 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1611
Practice Address - Country:US
Practice Address - Phone:708-547-8736
Practice Address - Fax:708-547-8513
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051296903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist