Organization
CENTRO MEDICO RUIZ-MONTERO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME RUIZ-MONTERO MD (PRESIDENT)
(219) 397-8965
Entity
Organization
Contact information
Practice address
4320 FIR ST, STE 410, EAST CHICAGO, IN 46312-3052
(219) 397-8965
(219) 397-9351
Mailing address
4320 FIR ST, STE 410, EAST CHICAGO, IN 46312-3052
(219) 397-8965
(219) 397-9351
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01052348
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110241554
MEDICARE RAILROAD
IN
05
—
200287720B
—
IN
Enumeration date
02/06/2006
Last updated
07/01/2008
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