Provider Demographics
NPI:1952511925
Name:RUBIS, LISA M (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:RUBIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 REPUBLIC AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6515
Mailing Address - Country:US
Mailing Address - Phone:815-207-7463
Mailing Address - Fax:
Practice Address - Street 1:115 REPUBLIC AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6515
Practice Address - Country:US
Practice Address - Phone:815-207-7463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4553826OtherCIGNA
ILK39985OtherMEDICARE PROVIDER NUMBER
IL711932OtherUNITED HEALTH CARE
IL9932535OtherBCBS PROVIDER #
IL711932OtherACN GROUP PROVIDER #