MEDICARE: SHELDON Z RUBIN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		IL

General Provider Information

NPI Number	:	1184894958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELDON Z RUBIN DPM

Provider Business Mailing Address
First Line	:	8100 W 95TH ST
Second Line	:
City	:	HICKORY HILLS
State	:	IL
Zip	:	60457-1964
Country	:	US
Telephone Number	:	708-598-0292
Fax Number	:	708-598-2952

Provider Business Practice Location Address
First Line	:	8100 W 95TH ST
Second Line	:
City	:	HICKORY HILLS
State	:	IL
Zip	:	60457-1964
Country	:	US
Telephone Number	:	708-598-0292
Fax Number	:	708-598-2952

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SHELDON ZALMON RUBIN
Credential	:	DPM
Telephone Number	:	708-598-0292

Provider Enumeration Date	:	03/07/2008
Last Update Date	:	07/21/2022

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