BRYAN W RUBACH (NPI# 1912926205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912926205 |
Entity Type | Individual |
Full Name | BRYAN W RUBACH |
Credential | M.D. |
Practice Address |
2040 Ogden Ave Ste 301 Aurora IL 60504-7205 |
Practice Telephone | 6309786895 |
Practice Fax Number | 6303752905 |
Mailing Telephone | 6309786895 |
Mailing Fax Number | 6303752905 |
Enumeration Date | 2006-07-18 |
Last Update Date | 2020-07-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
364032123 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BLUE CROSS BLUE SHIELD | 4506907 | 01 |
IL | F80995 | 05 | |
IL | RAILROAD MEDICARE | 040008621 | 01 |
Street Address |
2040 OGDEN AVE STE 301 |
City | AURORA |
State | IL |
Zip Code | 60504-7205 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124163845 | Cathleen Kovanic | Audiologist | 2040 Ogden Ave Ste 301, Aurora, IL 60504-7205 | 2007-02-20 |
1265451140 | Stephen M Kelanic | Otolaryngology | 2040 Ogden Ave Ste 301, Aurora, IL 60504-7205 | 2006-07-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134631039 | Kamala Lakshmipathy | Physical Therapist | 2021 Randi Drive, Aurora, IL 60504 | 2017-10-31 |
1891211710 | Kenneth Vicencio | Clinical Neuropsychologist | 4100 Healthway Drive, Aurora, IL 60504 | 2017-08-22 |
1316499023 | Wilcox and Wilcox, Inc | Home Health | 75 Executive Drive, Suite 301, Aurora, IL 60504 | 2016-10-28 |
1518315241 | Kinsley Jin | Family Medicine | Rush-copley Family Medicine Center 2020 Ogden Avenue, Suite 330, Aurora, IL 60504 | 2016-06-03 |
1609224211 | Empower Health Services, LLC | Clinic/Center | 4205 Westbrook Dr, Aurora, IL 60504 | 2016-05-25 |
1275907883 | Lolita Lajoyce Norris | Private Vehicle | 235 Kirkland Ln, Aurora, IL 60504 | 2015-11-19 |
1972917557 | Elizabeth Sledge | Occupational Therapist | 1000 Celebration Dr, Aurora, IL 60504 | 2014-06-11 |
1962840330 | Sparc Chiropractic, P.C. | Chiropractor | 800-2 Frontenac Road, #2, Aurora, IL 60504 | 2013-06-07 |
1932451952 | Illinois Health Resources Inc | Physical Therapist | 1240 S Commons Dr, Aurora, IL 60504 | 2012-10-15 |
1376894501 | Rush-copley Medical Group | Family Medicine | 2040 Ogden Ave., Suite 304, Aurora, IL 60504 | 2012-09-27 |
Find all providers in zip 60504 |
Taxonomy Code | 207YX0905X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
Specialization | Otolaryngology/Facial Plastic Surgery |
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326338526 | Sudeep Roy | Otolaryngology | 1640 N Arlington Heights Rd Ste 210, Arlington Heights, IL 60004-3985 | 2011-04-10 |
1487834958 | Ryan C Vaughn | Otolaryngology | 814 E Woodfield Rd, Schaumburg, IL 60173-4714 | 2007-11-13 |
1023214426 | Otolaryngology Associates Sc | Otolaryngology | 233 E Erie St Ste 804, Chicago, IL 60611-2906 | 2007-06-22 |
1982769717 | Anthony James Geroulis | Otolaryngology | 330 West Frontage Rd., Northfield, IL 60093 | 2006-12-22 |
1821191404 | Gary G Wiesman | Otolaryngology | 712 N Dearborn St, Chicago, IL 60654-3846 | 2006-09-07 |
1609805985 | Howard Shane Kotler | Otolaryngology | 2555 S. Martin Luther King Dr., Chicago, IL 60616 | 2006-06-30 |
1447288303 | Thomas E. Turcotte Jr. | Otolaryngology | 215 E. 1st St., Suite #315, Ksb Medical Group, Dixon, IL 61021 | 2006-06-29 |
1477184562 | Chicago Nose and Sinus LLC | Otolaryngology | 680 N Lake Shore Dr Ste 1425, Chicago, IL 60611-4451 | 2020-01-28 |
1780935197 | Jeffrey Ryan Sparks | Otolaryngology | 515 E Grant St, Suite 113, Macomb, IL 61455-3368 | 2012-09-25 |
1326321431 | Bernard Carl Pecaro | Otolaryngology | 383 S Schmale Rd, Carol Stream, IL 60188-2756 | 2011-09-25 |
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.