Healthcare Provider Details

I. General information

NPI: 1487571162
Provider Name (Legal Business Name): CYNTHIA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 N FRANCISCO AVE
CHICAGO IL
60622-2743
US

IV. Provider business mailing address

126 NORTHGATE RD
RIVERSIDE IL
60546-1617
US

V. Phone/Fax

Practice location:
  • Phone: 773-292-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number041446846
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: