Individual
MRS. KELLY RUBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
137 CEDAR AVENUE, LAKE VILLA, IL 60046
(847) 265-7300
(847) 265-7301
Mailing address
137 CEDAR AVENUE, PO BOX 764, LAKE VILLA, IL 60046
(847) 265-7300
(847) 265-7301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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