Provider Demographics
NPI:1801117130
Name:RUBENS, GERMAINE DABNEY (CRNA)
Entity type:Individual
Prefix:
First Name:GERMAINE
Middle Name:DABNEY
Last Name:RUBENS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CUSTER AVE
Mailing Address - Street 2:#1S
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-5225
Mailing Address - Country:US
Mailing Address - Phone:847-733-0386
Mailing Address - Fax:
Practice Address - Street 1:1770 1ST ST
Practice Address - Street 2:STE 703
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3200
Practice Address - Country:US
Practice Address - Phone:847-433-1539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041322308163W00000X
IL209008263367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse