Provider Demographics
NPI:1770918302
Name:FERGUSON, RONALD ALLAN (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ALLAN
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:17885 W POND RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1669
Mailing Address - Country:US
Mailing Address - Phone:847-356-0677
Mailing Address - Fax:847-356-0677
Practice Address - Street 1:17885 W POND RIDGE CIR
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-1669
Practice Address - Country:US
Practice Address - Phone:847-356-0677
Practice Address - Fax:847-356-0677
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.050560207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine