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NPI Code Detail

MEDICARE: JESUS EDGAR SUAREZ RAMOS LPC

MEDICARE: JESUS EDGAR SUAREZ RAMOS LPC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor178015113IL

General Provider Information

NPI Number : 1588277479
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESUS EDGAR SUAREZ RAMOS LPC
Provider Business Mailing Address
First Line : 2319 S DAMEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-4209
Country : US
Telephone Number : 773-579-0832
Fax Number :
Provider Business Practice Location Address
First Line : 2319 S DAMEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-4209
Country : US
Telephone Number : 773-579-0832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 08/28/2020

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