Healthcare Provider Details

I. General information

NPI: 1912812033
Provider Name (Legal Business Name): BENJAMIN ALEJANDRO RAMIREZ M.S-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 W CALISTA ST
KANKAKEE IL
60901-3210
US

IV. Provider business mailing address

746 S EVERGREEN AVE
KANKAKEE IL
60901-5321
US

V. Phone/Fax

Practice location:
  • Phone: 815-933-0760
  • Fax:
Mailing address:
  • Phone: 815-295-7094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number242.018701
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: