Provider Demographics
NPI:1275788911
Name:RAMIREZ, MAUREEN DIANE (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:DIANE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:MISS
Other - First Name:MAUREEN
Other - Middle Name:DIANE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP/L
Mailing Address - Street 1:2530 ERIE ST
Mailing Address - Street 2:
Mailing Address - City:RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60171-1714
Mailing Address - Country:US
Mailing Address - Phone:708-692-6520
Mailing Address - Fax:
Practice Address - Street 1:2530 ERIE ST
Practice Address - Street 2:
Practice Address - City:RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60171-1714
Practice Address - Country:US
Practice Address - Phone:708-692-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.000802235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist