Mr Willie J Rucker, DDS is a
Dentist based in Markham, Illinois. Mr Willie J Rucker is licensed to practice in Illinois (license number ) and his current practice location is
16048 Kedzie Avenue, Markham, Illinois. He can be reached at his office (for appointments etc.) via phone at
(708) 331-4999.
NPI number for Mr Willie J Rucker is 1205870169 and his current mailing address is Po Box 0278, 16048 Kedzie Avenue, Markham, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1205870169.
Healthcare Provider's Profile
| Full Name | Mr Willie J Rucker |
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| Gender | Male |
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| Speciality | Dentist |
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| Location | 16048 Kedzie Avenue, Markham, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1205870169
- Provider Enumeration Date: 06/15/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Willie J Rucker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205870169 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 12009827B (Indiana) | Secondary |
| 122300000X | Dentist | (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Willie J Rucker is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Willie J Rucker, DDS
Po Box 0278, 16048 Kedzie Avenue,
Markham, IL 60428
Ph: (708) 331-4999 | Mr Willie J Rucker, DDS
16048 Kedzie Avenue,
Markham, IL 60428
Ph: (708) 331-4999 |
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