MEDICARE: JOSEFINA RAMOS LARDUET

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1174481642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEFINA RAMOS LARDUET

Provider Business Mailing Address
First Line	:	4842 ANTIOCH DR
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61109-3187
Country	:	US
Telephone Number	:	815-558-9094
Fax Number	:

Provider Business Practice Location Address
First Line	:	2859 S PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-5095
Country	:	US
Telephone Number	:	234-225-4891
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	JOSEFINA RAMOS LARDUET
Credential	:	NP
Telephone Number	:	815-558-9094

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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