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Individual

DR. CRYSTAL D RUFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10400 75TH ST, AURORA KENOSHA MEDICAL CENTER, KENOSHA, WI 53142-7884
(262) 948-5600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 948-6790

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036113956
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
45194
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036113956
IL
05
1285668525
WI
Enumeration date
07/11/2006
Last updated
10/11/2023
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