Provider Demographics
NPI:1588700462
Name:DORUSHKA, RON W (RRT)
Entity type:Individual
Prefix:
First Name:RON
Middle Name:W
Last Name:DORUSHKA
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2753 MC DUFFEE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-2030
Mailing Address - Country:US
Mailing Address - Phone:630-907-2337
Mailing Address - Fax:
Practice Address - Street 1:2753 MC DUFFEE CIR
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-2030
Practice Address - Country:US
Practice Address - Phone:630-907-2337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILVAD000Medicare UPIN