Provider Demographics
NPI:1205162906
Name:MARGARET A RUZICH PC
Entity type:Organization
Organization Name:MARGARET A RUZICH PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUZICH
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:815-464-9195
Mailing Address - Street 1:22108 PRINCETON CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8503
Mailing Address - Country:US
Mailing Address - Phone:815-464-9195
Mailing Address - Fax:815-464-9196
Practice Address - Street 1:22108 PRINCETON CIR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-8503
Practice Address - Country:US
Practice Address - Phone:815-464-9195
Practice Address - Fax:815-464-9196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty