Healthcare Provider Details

I. General information

NPI: 1033099445
Provider Name (Legal Business Name): RUTI SARIS GREENFIELD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E WACKER DR STE 1130
CHICAGO IL
60601-5227
US

IV. Provider business mailing address

1029 W NORTH SHORE AVE APT 3W
CHICAGO IL
60626-4632
US

V. Phone/Fax

Practice location:
  • Phone: 312-934-7701
  • Fax:
Mailing address:
  • Phone: 312-934-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.023405
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: