Provider Demographics
NPI:1750176673
Name:RUFO, LAURA (LAC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:RUFO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 W LELAND AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-9864
Mailing Address - Country:US
Mailing Address - Phone:773-457-2934
Mailing Address - Fax:
Practice Address - Street 1:2209 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-6084
Practice Address - Country:US
Practice Address - Phone:773-227-9150
Practice Address - Fax:773-227-9160
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001689171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist