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General NPI Number Information
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NPI Number | 1114796687
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Entity Type | Organization
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Legal Business Name | ALTAR HEALTHCARE GROUP, PLLC
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Dates
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Enumeration Date | 12/26/2023
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 2501 CHATHAM RD STE N
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City | SPRINGFIELD
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State | IL
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Zip | 62704
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Country | US
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Telephone | 773-704-0626
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 CHATHAM RD STE N
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City | SRINGFIELD
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State | IL
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Zip | 62704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | MARYBELL RAMIREZ
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Credential | APRN, FNP
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Telephone | 773-704-0626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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