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Individual

AMADO RUEDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6035 W CERMAK RD, CICERO, IL 60804-2021
(708) 656-5230
(708) 656-6610
Mailing address
9680 GOLF RD, DES PLAINES, IL 60016-1522
(847) 699-0800
(847) 296-5686

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-090568
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036090568
IL
01
K30406
MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
06/26/2006
Last updated
12/03/2020
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