Individual
RUJU VIVEK TRIVEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 W COURT ST STE 214, KANKAKEE, IL 60901-3674
(815) 928-6131
Mailing address
555 W COURT ST STE 214, KANKAKEE, IL 60901-3674
(815) 928-6131
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010923
IL
Other
Enumeration date
03/22/2023
Last updated
11/18/2024
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