Healthcare Provider Details

I. General information

NPI: 1053224774
Provider Name (Legal Business Name): ADAM RUFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 S LINCOLNWAY
NORTH AURORA IL
60542-1658
US

IV. Provider business mailing address

39W335 WEAVER LN
GENEVA IL
60134-6061
US

V. Phone/Fax

Practice location:
  • Phone: 630-859-2504
  • Fax:
Mailing address:
  • Phone: 708-710-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number041410301
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: