Healthcare Provider Details

I. General information

NPI: 1427145200
Provider Name (Legal Business Name): PAUL RUZILA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E WISCONSIN AVE STE 15
LAKE FOREST IL
60045-1701
US

IV. Provider business mailing address

222 E WISCONSIN AVE STE 15
LAKE FOREST IL
60045-1701
US

V. Phone/Fax

Practice location:
  • Phone: 312-212-1150
  • Fax:
Mailing address:
  • Phone: 312-212-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038010078
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: