Provider Demographics
NPI:1952475451
Name:HUGAR, RONALD WALTER (DPM)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:WALTER
Last Name:HUGAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4302
Mailing Address - Country:US
Mailing Address - Phone:708-452-6100
Mailing Address - Fax:708-452-1614
Practice Address - Street 1:1614 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-4302
Practice Address - Country:US
Practice Address - Phone:708-452-6100
Practice Address - Fax:708-452-1614
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0060000059OtherBCBS
IL0060000059OtherBCBS
ILT36765Medicare UPIN