| Doctor Name: | DIEDRE RUVA |
| NPI Number: | 1194115808 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPHT |
| License Number: | 049.150456 |
| Business Practice Address: | 2333 63rd St Woodridge, IL - 605171300 |
| Business Phone Number: | 6304340303 |
| Business Fax Number: | 6308741915 |
| Mailing Address: | 2333 63rd St, WOODRIDGE |
| State: | IL |
| Postal Code: | 605171300 |
| Phone Number: | 6304340303 |
| Fax Number: | 6308741915 |
| NPI Enumeration Date: | 02/02/2015 |
| NPI Last Update Date: | 02/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 183700000X |
| License Number: | 049.150456 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacy Technician |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |