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General NPI Number Information
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NPI Number | 1558183582
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Entity Type | Individual
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Provider Name | MARTHA DELIA RAMIREZ RDH,BS,PHDH
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 1285 HARTREY AVE
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City | EVANSTON
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State | IL
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Zip | 60202-1056
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Country | US
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Telephone | 847-666-3494
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Fax |
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Provider Business Mailing Address
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Address Line | 6211 W BELLE PLAINE AVE
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City | CHICAGO
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State | IL
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Zip | 60634-1518
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Country | US
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Telephone | 312-307-5199
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 020.009668
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License Number State | IL
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