MR. WILLIE J RUCKER (NPI# 1205870169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205870169 |
| Entity Type | Individual |
| Full Name | MR. WILLIE J RUCKER |
| Credential | DDS |
| Practice Address |
16048 Kedzie Avenue Markham IL 60428 |
| Mailing Address |
Po Box 0278 16048 Kedzie Avenue Markham IL 60428 |
| Practice Telephone | 7083314999 |
| Practice Fax Number | 7083315043 |
| Mailing Telephone | 7083314999 |
| Mailing Fax Number | 7083315043 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 12009827B | IN | Dental Providers |
| Y | 122300000X | Dentist | IL | Dental Providers |
| Street Address |
16048 KEDZIE AVENUE |
| City | MARKHAM |
| State | IL |
| Zip Code | 60428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689157026 | Sarah Carr | Speech-Language Pathologist | 16315 Richmond Avenue, Markham, IL 60428 | 2018-09-12 |
| 1619156247 | Z and P Transportation Inc | Secured Medical Transport (VAN) | 16422 California Ave, Markham, IL 60428 | 2007-10-31 |
| 1689921777 | Green Energy Group | Preferred Provider Organization | 16643 Kedzie Ave, Suite 102, Markham, IL 60428 | 2012-08-08 |
| 1144367715 | Stanley Melvin Robinson | Occupational Therapist | 15125 Sacramento St, Markham, IL 60428-2733 | 2007-01-31 |
| 1255788774 | Versatile Transportation LLC | Non-emergency Medical Transport (VAN) | 3355 Heather Dr, Markham, IL 60428-2773 | 2016-05-16 |
| 1679020739 | Empress Home Healthcare Inc. | Home Health | 15652 Homan Ave, Ste 15, Markham, IL 60428-3825 | 2016-09-07 |
| 1386886794 | Changing Futures | Private Vehicle | 15813 Clifton Park Ave, Markham, IL 60428-3920 | 2009-03-31 |
| 1326280462 | Loretta L Bayless | Private Vehicle | 15813 Clifton Park Ave, Markham, IL 60428-3920 | 2009-04-06 |
| 1003196973 | Welllife-a Subsidiary of Innovative Sustainable Solutions | Community/Behavioral Health | 15808 Clifton Park Ave, Markham, IL 60428-3921 | 2011-08-24 |
| 1417962549 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 15940 Kedzie Ave, Markham, IL 60428-4017 | 2006-07-29 |
| Find all providers in zip 60428 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629076 | Align Dental Group PC. | Dentist | 2605 Grand Ave Ste A, Waukegan, IL 60085-2410 | 2020-11-06 |
| 1881293801 | Wh Il Dental Pllc | Dentist | 18086 N. Kilpatrick Ave., Chicago, IL 60639 | 2020-10-21 |
| 1982201505 | Ashley Rodriguez | Dentist | 2208 N Mannheim Rd, Melrose Park, IL 60164-1837 | 2020-10-06 |
| 1831796853 | Shaista Hasan | Dentist | 1840 Harvest Ln, Glendale Heights, IL 60139-1939 | 2020-10-02 |
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1477160190 | Smilesbysangha LLC | Dentist | 118 Barrington Commons Ct Ste 201, Barrington, IL 60010-3259 | 2020-09-27 |
| 1477160331 | Samer Mosoof | Dentist | 9 Monroe Ct, Streamwood, IL 60107-1365 | 2020-09-24 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1275145534 | Moondrift Sleep Solutions, LLC | Dentist | 837 N Wilke Rd, Arlington Heights, IL 60005-1047 | 2020-08-18 |
| 1023629664 | Mockunas Dental PC | Dentist | 13530 S Route 59 Unit 120, Plainfield, IL 60544-5659 | 2020-08-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.