Healthcare Provider Details

I. General information

NPI: 1336768498
Provider Name (Legal Business Name): MARICRUZ RAMOS EDD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1786 MOON LAKE BLVD
HOFFMAN ESTATES IL
60169-5029
US

IV. Provider business mailing address

1786 MOON LAKE BLVD
HOFFMAN ESTATES IL
60169-5029
US

V. Phone/Fax

Practice location:
  • Phone: 847-220-4324
  • Fax:
Mailing address:
  • Phone: 847-220-4324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.017144
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: