Healthcare Provider Details

I. General information

NPI: 1629799903
Provider Name (Legal Business Name): FRANCIS RUANE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FRANK RUANE

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15900 W 127TH ST STE 201
LEMONT IL
60439-2912
US

IV. Provider business mailing address

11300 S DEPOT ST
WORTH IL
60482-2047
US

V. Phone/Fax

Practice location:
  • Phone: 630-281-2496
  • Fax:
Mailing address:
  • Phone: 708-382-1902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: