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NPI Code Detail

MEDICARE: DR. NICHOLAS RUGGIO D.D.S.

MEDICARE:  DR. NICHOLAS  RUGGIO  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019029421IL

General Provider Information

NPI Number : 1891134128
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS RUGGIO D.D.S.
Provider Business Mailing Address
First Line : 845 W ALTGELD ST
Second Line : APT 3A
City : CHICAGO
State : IL
Zip : 60614-6451
Country : US
Telephone Number : 847-997-9681
Fax Number :
Provider Business Practice Location Address
First Line : 2518 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2782
Country : US
Telephone Number : 773-871-4664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2013
Last Update Date : 06/19/2013

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Directions to “ DR. NICHOLAS RUGGIO D.D.S.” Practice Location

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