Individual
JAMES RUPP JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S FIRST AVE, (321 N. LAGRANGE RD., LAGRANGE PRK, IL. 60526), MAYWOOD, IL 60153
(708) 485-1020
(708) 485-1173
Mailing address
2160 S FIRST AVE, (321 N. LAGRANGE RD., LAGRANGE PRK, IL. 60526), MAYWOOD, IL 60153
(708) 485-1020
(708) 485-1173
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36106896
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36106896
—
IL
01
—
K21172
MEDICARE
IL
Enumeration date
02/15/2006
Last updated
09/01/2022
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