Individual
RUBEN P DETTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1425 N RANDALL RD, ELGIN, IL 60123-2300
(630) 456-5593
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041431339
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209.023868
IL
Other
Enumeration date
07/16/2021
Last updated
10/11/2023
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