MEDICARE: RUTH A WOROCH N.P.

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	363L00000X	Nurse Practitioner	277001681	IL

General Provider Information

NPI Number	:	1316963572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH A WOROCH N.P.

Provider Business Mailing Address
First Line	:	4423 N RAVENSWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5802
Country	:	US
Telephone Number	:	773-432-6570
Fax Number	:	773-681-0839

Provider Business Practice Location Address
First Line	:	4423 N RAVENSWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5802
Country	:	US
Telephone Number	:	773-432-6570
Fax Number	:	773-681-0839

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	12/09/2021

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