Individual
MS. RUBY L. FLAGG-ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
12200 S PERRY AVE, CHICAGO, IL 60628-6827
(773) 568-5567
Mailing address
12200 S PERRY AVE, CHICAGO, IL 60628-6827
(773) 568-5567
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V010600
SOCIAL WORKER
IL
Enumeration date
09/15/2006
Last updated
07/08/2007
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