Individual
DR. PHYLLIS B RUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY D
Contact information
Practice address
715 LAKE ST, SUITE 720, OAK PARK, IL 60301
(708) 848-0983
(708) 848-0465
Mailing address
715 LAKE ST, SUITE 720, OAK PARK, IL 60301
(708) 848-0983
(708) 848-0465
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071005880
IL
235Z00000X
Speech-Language Pathologist
146001732
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31623351
BCBS
IL
01
—
31623353
BCBS
IL
05
—
3781254014
—
IL
Enumeration date
11/17/2006
Last updated
10/27/2008
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