MEDICARE: ALTAR HEALTHCARE GROUP, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	213E00000X	Podiatrist
3	207X00000X	Orthopaedic Surgery Physician
4	207N00000X	Dermatology Physician
5	207W00000X	Ophthalmology Physician
6	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1114796687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTAR HEALTHCARE GROUP, PLLC

Provider Business Mailing Address
First Line	:	10448 S PULASKI RD STE 6
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-4895
Country	:	US
Telephone Number	:	708-932-3260
Fax Number	:

Provider Business Practice Location Address
First Line	:	10448 S PULASKI RD STE 6
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-4895
Country	:	US
Telephone Number	:	708-932-3260
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MARYBELL RAMIREZ
Credential	:	APRN
Telephone Number	:	708-932-3260

Provider Enumeration Date	:	12/26/2023
Last Update Date	:	04/06/2026

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