Provider Demographics
NPI:1023086832
Name:RUBEL, NICHOLAS M (ATC)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:M
Last Name:RUBEL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 N HOYNE AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-8208
Mailing Address - Country:US
Mailing Address - Phone:773-370-2452
Mailing Address - Fax:
Practice Address - Street 1:1500 WAUKEGAN RD
Practice Address - Street 2:SUITE 250
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-2100
Practice Address - Country:US
Practice Address - Phone:847-657-9445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer