Healthcare Provider Details

I. General information

NPI: 1558833699
Provider Name (Legal Business Name): MARYBELL RAMIREZ APRN-FPA, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2018
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10448 S PULASKI RD STE 6
OAK LAWN IL
60453-4895
US

IV. Provider business mailing address

10448 S PULASKI RD STE 6
OAK LAWN IL
60453-4895
US

V. Phone/Fax

Practice location:
  • Phone: 708-932-3260
  • Fax:
Mailing address:
  • Phone: 708-932-3260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277002942
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: