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Individual

LUIS E RUEDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
711 W NORTH AVE, CHICAGO, IL 60610-1174
(312) 337-1982
Mailing address
711 W NORTH AVE, CHICAGO, IL 60610-1174
(312) 337-1982

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036091856
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036091856
IL STATE LICENSE #
IL
05
036091856
IL
Enumeration date
08/29/2006
Last updated
07/21/2022
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