Provider Demographics
NPI:1518908540
Name:VALENTIN, RUTH ROSE (ARNP)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ROSE
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:ROSE
Other - Last Name:VALENTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1051 ESSINGTON RD STE 250
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-2803
Mailing Address - Country:US
Mailing Address - Phone:815-300-7764
Mailing Address - Fax:
Practice Address - Street 1:1051 ESSINGTON RD STE 250
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2803
Practice Address - Country:US
Practice Address - Phone:815-300-7764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9187993363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL050540914OtherTAX-ID
IL$$$$$$$$$Medicaid
ILP00130032/CK6882OtherRAILROAD MEDICARE PIN
IL4673170001OtherDMERC
IL01633122OtherBCBS
IL01633122OtherBCBS