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General NPI Number Information
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NPI Number | 1861121378
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Entity Type | Individual
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Provider Name | ASHLEY RUIZ MSW
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 1400 S AUSTIN BLVD
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City | CICERO
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State | IL
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Zip | 60804-1003
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Country | US
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Telephone | 312-613-4761
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Fax |
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Provider Business Mailing Address
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Address Line | 5645 W. CORCORAN
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City | CHICAGO
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State | IL
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Zip | 60644
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Country | US
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Telephone | 312-613-4761
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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