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NPI Code Detail

MEDICARE: GONZALO RAMIREZ SALDIVAR

MEDICARE: GONZALO RAMIREZ SALDIVAR
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
1225200000XPhysical Therapy Assistant

General Provider Information

NPI Number : 1801514914
Entity Type Code : Individual
Provider Name (Legal Business Name) : GONZALO RAMIREZ SALDIVAR
Provider Business Mailing Address
First Line : 3551 HIGHLAND AVE STE 100
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-2160
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3551 HIGHLAND AVE STE 100
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-2160
Country : US
Telephone Number : 630-275-2600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2022
Last Update Date : 08/16/2022

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Directions to “ GONZALO RAMIREZ SALDIVAR ” Practice Location

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