Provider Demographics
NPI:1932335130
Name:RUGGIERI, RAFAEL MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:MIGUEL
Last Name:RUGGIERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:101 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3909
Mailing Address - Country:US
Mailing Address - Phone:217-366-1228
Mailing Address - Fax:217-366-6106
Practice Address - Street 1:3101 FIELDS SOUTH DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-3743
Practice Address - Country:US
Practice Address - Phone:217-366-1228
Practice Address - Fax:217-366-6106
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036141048208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery