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General NPI Number Information
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NPI Number | 1649237702
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Entity Type | Individual
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Provider Name | SAMUEL RAMIREZ D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5723 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-2306
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Country | US
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Telephone | 773-622-8060
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Fax | 773-622-8095
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Provider Business Mailing Address
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Address Line | 4918 N MAGNOLIA AVE
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City | CHICAGO
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State | IL
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Zip | 60640-3507
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Country | US
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Telephone | 773-728-0989
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Fax | 773-728-1062
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016004751
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License Number State | IL
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