Provider Demographics
NPI:1821378308
Name:RUBIS, EVERETT FRANK (RPH)
Entity type:Individual
Prefix:MR
First Name:EVERETT
Middle Name:FRANK
Last Name:RUBIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-2335
Mailing Address - Country:US
Mailing Address - Phone:847-824-7038
Mailing Address - Fax:
Practice Address - Street 1:5935 W ADDISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4214
Practice Address - Country:US
Practice Address - Phone:773-282-1594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051032487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist