Provider Demographics
NPI:1720279573
Name:RUBAN, DMITRY SERGEI (MD)
Entity Type:Individual
Prefix:DR
First Name:DMITRY
Middle Name:SERGEI
Last Name:RUBAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2040 OGDEN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7205
Mailing Address - Country:US
Mailing Address - Phone:630-978-6770
Mailing Address - Fax:630-978-6773
Practice Address - Street 1:2040 OGDEN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7206
Practice Address - Country:US
Practice Address - Phone:630-978-6770
Practice Address - Fax:630-978-6773
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.119486207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery