MEDICARE: DR. JENNIFER S. RAMOS DC

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	111N00000X	Chiropractor	038-007291	IL

General Provider Information

NPI Number	:	1215048947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER S. RAMOS DC

Provider Business Mailing Address
First Line	:	524. N. LAKE ST
Second Line	:
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-1827
Country	:	US
Telephone Number	:	847-949-4200
Fax Number	:	847-949-4853

Provider Business Practice Location Address
First Line	:	524. N. LAKE ST
Second Line	:
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-1827
Country	:	US
Telephone Number	:	847-949-4200
Fax Number	:	847-949-4853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/27/2009

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