Individual
DR. EDWARD A RUFUS JR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5401 N KNOXVILLE AVE, SUITE 306, PEORIA, IL 61614-5098
(309) 691-7890
(309) 691-7898
Mailing address
206 E MILLER RD, EDELSTEIN, IL 61526-9740
(309) 274-5200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036073126
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073126
—
IL
01
—
7200599
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/10/2005
Last updated
10/14/2009
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