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NPI Code Detail

MEDICARE: DR. CARMEN T RAMOS IRIZARRY

MEDICARE: DR. CARMEN T RAMOS IRIZARRY
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
12086S0120XPediatric Surgery PhysicianME108119FL
22086S0120XPediatric Surgery Physician036174183IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922081363
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARMEN T RAMOS IRIZARRY
Provider Business Mailing Address
First Line : 150 HARVESTER DR STE 300
Second Line :
City : BURR RIDGE
State : IL
Zip : 60527-5965
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5841 S MARYLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1443
Country : US
Telephone Number : 888-824-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 08/06/2025

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