Healthcare Provider Details

I. General information

NPI: 1295299352
Provider Name (Legal Business Name): YVETTE RAMIREZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6250 W NORTH AVE
CHICAGO IL
60639-3861
US

IV. Provider business mailing address

6250 W NORTH AVE
CHICAGO IL
60639-3861
US

V. Phone/Fax

Practice location:
  • Phone: 773-622-6218
  • Fax: 773-622-7440
Mailing address:
  • Phone: 773-622-6218
  • Fax: 773-622-7440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.014045
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.014563
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: