MEDICARE: PAMELA KAY RUFFER PSY.D.

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	103TC0700X	Clinical Psychologist	071007701	IL

General Provider Information

NPI Number	:	1356599336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA KAY RUFFER PSY.D.

Provider Business Mailing Address
First Line	:	200 E EVERGREEN AVE STE 130
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-3294
Country	:	US
Telephone Number	:	630-539-0217
Fax Number	:	847-749-1438

Provider Business Practice Location Address
First Line	:	200 E EVERGREEN AVE STE 130
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-3294
Country	:	US
Telephone Number	:	630-539-0217
Fax Number	:	847-749-1438

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

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	12/03/2025

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