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General NPI Number Information
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NPI Number | 1982394961
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Entity Type | Individual
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Provider Name | GEELA JILL RUCKMAN AGACNP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 900 N 1ST ST FL 3
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City | SPRINGFIELD
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State | IL
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Zip | 62702-3749
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Country | US
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Telephone | 217-528-7541
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Fax |
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Provider Business Mailing Address
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Address Line | 13 CHURCHILL DR
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City | CHATHAM
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State | IL
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Zip | 62629-1227
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Country | US
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Telephone | 217-473-7660
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209027406
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License Number State | IL
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