Organization
LOGAN SQUARE MEDICAL INSTITUTE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GONZALO RUIZ M.D. (PHYSICIAN)
(773) 772-7899
Entity
Organization
Contact information
Practice address
3061 W. LOGAN BLVD, CHICAGO, IL 60647-1707
(773) 772-7899
(773) 772-7896
Mailing address
3061 W. LOGAN BLVD, CHICAGO, IL 60647
(773) 772-7899
(773) 772-7896
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/22/2011
Last updated
02/09/2015
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