Individual
BRYAN W RUBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2040 OGDEN AVE STE 301, AURORA, IL 60504-7205
(630) 978-6895
(630) 375-2905
Mailing address
2040 OGDEN AVE STE 301, AURORA, IL 60504-7205
(630) 978-6895
(630) 375-2905
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
364032123
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040008621
RAILROAD MEDICARE
IL
01
—
4506907
BLUE CROSS BLUE SHIELD
IL
05
—
F80995
—
IL
Enumeration date
07/18/2006
Last updated
07/20/2020
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