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General NPI Number Information
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NPI Number | 1639120785
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Entity Type | Individual
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Provider Name | DAVID DE RAMOS DO
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Gender | Male
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 303 E ARMY TRAIL RD SUITE 300
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2169
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Country | US
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Telephone | 630-545-8300
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Fax | 630-980-9736
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Provider Business Mailing Address
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Address Line | 303 E ARMY TRAIL RD STE 300
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2169
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Country | US
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Telephone | 630-545-8300
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Fax | 630-980-9736
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36081151
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License Number State | IL
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