Provider Demographics
NPI:1487124335
Name:RUIZ, ALBEZA VERONICA (RN)
Entity type:Individual
Prefix:MRS
First Name:ALBEZA
Middle Name:VERONICA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 199TH ST
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60411-9665
Mailing Address - Country:US
Mailing Address - Phone:312-945-2198
Mailing Address - Fax:
Practice Address - Street 1:2331 199TH ST
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60411-9665
Practice Address - Country:US
Practice Address - Phone:312-945-2198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041366923163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management