MEDICARE: ZYLVIA RAMOS

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	252Y00000X	Early Intervention Provider Agency		IL

General Provider Information

NPI Number	:	1689982662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZYLVIA RAMOS

Provider Business Mailing Address
First Line	:	247 N NELTNOR BLVD APT A1D
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-2326
Country	:	US
Telephone Number	:	630-520-0099
Fax Number	:	630-520-0099

Provider Business Practice Location Address
First Line	:	247 N NELTNOR BLVD APT A1D
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-2326
Country	:	US
Telephone Number	:	630-520-0099
Fax Number	:	630-520-0099

Authorized Official
Title or Position	:	INTERPRETER
Name	:	MRS. ZYLVIA RAMOS
Credential	:
Telephone Number	:	630-520-0099

Provider Enumeration Date	:	09/23/2010
Last Update Date	:	09/23/2010

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