Organization
PEORIA PODIATRY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DANIEL RUFF DPM (PRESIDENT)
(309) 637-3668
Entity
Organization
Contact information
Practice address
614 SPRING ST, PEORIA, IL 61603-4133
(309) 637-2325
Mailing address
614 SPRING ST, PEORIA, IL 61603-4133
(309) 637-2325
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
016003701
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016003701
—
IL
01
—
1366440166
JOHN D RUFF DPM
IL
01
—
1588813133 (GRP NPI)
ASSOCIATE--RACHEL S GRIEDER, DPM
IL
01
—
1588813133(GRP.NPI)
JOHN D RUFF DPM
IL
01
—
1598926289(INDNPI)
ASSOCIATE-RACHEL S GRIEDER, DPM
IL
Enumeration date
09/18/2008
Last updated
07/24/2009
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