Provider Demographics
NPI:1184894958
Name:SHELDON Z RUBIN DPM
Entity type:Organization
Organization Name:SHELDON Z RUBIN DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:ZALMON
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-598-0292
Mailing Address - Street 1:8100 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1964
Mailing Address - Country:US
Mailing Address - Phone:708-598-0292
Mailing Address - Fax:708-598-2952
Practice Address - Street 1:8100 W 95TH ST
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-1964
Practice Address - Country:US
Practice Address - Phone:708-598-0292
Practice Address - Fax:708-598-2952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL521073Medicare PIN
ILT36916Medicare UPIN
IL0776500002Medicare NSC
IL0776500001Medicare NSC
IL521070Medicare PIN