MEDICARE: RUBY ROY MD

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	208000000X	Pediatrics Physician	36084272	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447224456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBY ROY MD

Provider Business Mailing Address
First Line	:	405 LAKE ZURICH RD
Second Line	:
City	:	BARRINGTON
State	:	IL
Zip	:	60010-3141
Country	:	US
Telephone Number	:	847-381-5599
Fax Number	:	847-381-1431

Provider Business Practice Location Address
First Line	:	405 LAKE ZURICH RD
Second Line	:
City	:	BARRINGTON
State	:	IL
Zip	:	60010-3141
Country	:	US
Telephone Number	:	847-381-5599
Fax Number	:	847-381-1431

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	01/27/2022

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Directions to “ RUBY ROY MD” Practice Location

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