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General NPI Number Information
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NPI Number | 1114905874
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Entity Type | Individual
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Provider Name | BRADLEY E RUFF M.D.,
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Gender | Male
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 900 N WESTMORELAND RD LL84
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City | LAKE FOREST
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State | IL
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Zip | 60045-1674
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Country | US
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Telephone | 847-295-0001
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Fax | 847-535-9782
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Provider Business Mailing Address
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Address Line | 900 N WESTMORELAND RD LL84
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City | LAKE FOREST
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State | IL
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Zip | 60045-1674
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Country | US
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Telephone | 847-295-0001
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Fax | 847-535-9782
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036062774
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License Number State | IL
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