DR. DOMINADOR PADUA RUIZ (NPI# 1861524407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861524407 |
| Entity Type | Individual |
| Full Name | DR. DOMINADOR PADUA RUIZ |
| Credential | M.D. |
| Practice Address |
3412 W Fullerton Ave Chicago IL 60647-2416 |
| Mailing Address |
3950 W Jarlath St Lincolnwood IL 60712-1018 |
| Practice Telephone | 7732358000 |
| Mailing Telephone | 8479829166 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2008-11-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
036-059474 | IL | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
036-059474 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 1635693 | 01 |
| IL | 036059474 2 | 05 | |
| IL | BCBS GROUP | 1638831 | 01 |
| Street Address |
3412 W FULLERTON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60647-2416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205964103 | Fullerton Kimball Medical & Surgical Center | Clinic/Center | 3412 W Fullerton Ave, Chicago, IL 60647-2416 | 2007-03-01 |
| 1992289599 | Liauw Devi Gunawan | Nurse Practitioner | 3412 W Fullerton Ave, Chicago, IL 60647-2416 | 2018-09-19 |
| 1962845289 | Integrated Pain Management Sc | Anesthesiology | 3412 W Fullerton Ave, Chicago, IL 60647-2416 | 2013-04-17 |
| 1376771576 | Gregory Wells | Anesthesiology | 3412 W Fullerton Ave, Chicago, IL 60647-2416 | 2009-06-25 |
| 1801914791 | Cmp Professional Services | Anesthesiology | 3412 W Fullerton Ave, Chicago, IL 60647-2416 | 2007-03-27 |
| 1912021726 | Miguel Cua | Anesthesiology | 3412 W Fullerton Ave, Chicago, IL 60647 | 2007-03-19 |
| 1831213081 | Fullerton Kimball Medical Group PC | Clinic/Center | 3412 W Fullerton Ave, Chicago, IL 60647-2416 | 2007-03-16 |
| 1790809960 | Renlin Xia | Anesthesiology | 3412 W Fullerton Ave, Chicago, IL 60647-2416 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1003424458 | Emily Gleesing | Physical Therapist | 1923 N Western Ave, Chicago, IL 60647 | 2020-07-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1740772342 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 3n, Chicago, IL 60647 | 2018-05-31 |
| 1992297535 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 2n, Chicago, IL 60647 | 2018-05-30 |
| 1942704580 | Team Rehabilitation Il15, LLC | Physical Therapist | 1923 N Western Avenue, Chicago, IL 60647 | 2018-03-20 |
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1023537693 | Erin Frommeyer | Physician Assistant | 2228 W Dickens Avenue, Chicago, IL 60647 | 2017-09-15 |
| 1457872475 | Stefanie Paola Maurtua | Behavioral Analyst | 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 | 2017-06-29 |
| 1700322922 | Lumen Optical Illinois 4, LLC | Optometrist | 2420 N Elston, Bucktown, IL 60647 | 2017-01-11 |
| Find all providers in zip 60647 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407484645 | Macumber Medical Ltd | Clinic/Center | 3114 W Irving Park Rd Ste 1w, Chicago, IL 60618-3435 | 2020-04-01 |
| 1689226318 | Midway Spine and Joint Pain Physicians | Clinic/Center | 5720 S Pulaski Rd, Chicago, IL 60629-4435 | 2019-07-12 |
| 1497215933 | Activate Healthcare | Clinic/Center | 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 | 2019-03-21 |
| 1689989717 | A Better Weigh, Inc | Clinic/Center | 1931 W 95th St, Chicago, IL 60643-1105 | 2010-08-12 |
| 1598086399 | Bernadette B Mayer Md Sc | Clinic/Center | 5365 W Devon Ave, Chicago, IL 60646-4142 | 2010-06-15 |
| 1124295340 | Demetrios Petrovas M.d. S.c. | Clinic/Center | 3960 North Harlem Ave, Chicago, IL 60634-2219 | 2008-05-15 |
| 1689841801 | Petrovas Medical Center, S.c | Clinic/Center | 5962 N Lincoln Ave Ste 12, Chicago, IL 60659-3762 | 2008-05-15 |
| 1952577926 | Jefferson Park Medical Center, Ltd. | Clinic/Center | 4955 N Milwaukee Ave Ste 4, Chicago, IL 60630-2175 | 2008-04-30 |
| 1194833616 | Wicker Park Chiropractic Health | Clinic/Center | 2300 W North Ave, Chicago, IL 60647-5659 | 2006-08-25 |
| 1073567541 | Horizon Dante Pimentel | Clinic/Center | 4402 W Lawrence Ave, Chicago, IL 60630-2511 | 2006-05-20 |
| Find all providers in CHICAGO | ||||
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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.