Individual
VIOLET RUZICKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
6529 26TH PL, BERWYN, IL 60402-4701
(708) 603-1431
Mailing address
6529 26TH PL, BERWYN, IL 60402-4701
(708) 603-1431
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
17-694
IL
Other
Enumeration date
02/18/2018
Last updated
02/18/2018
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