Provider Demographics
NPI:1487431086
Name:RUFF, EVAN JACOB
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:JACOB
Last Name:RUFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29W405 FORESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-2104
Mailing Address - Country:US
Mailing Address - Phone:630-644-6500
Mailing Address - Fax:
Practice Address - Street 1:29W405 FORESTVIEW DR
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-2104
Practice Address - Country:US
Practice Address - Phone:630-644-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker