Provider Demographics
NPI:1376585877
Name:RAMOS, TERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W ADAMS ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-3665
Mailing Address - Country:US
Mailing Address - Phone:312-441-5501
Mailing Address - Fax:
Practice Address - Street 1:550 W ADAMS ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-3665
Practice Address - Country:US
Practice Address - Phone:312-441-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036082818207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1619414OtherBCBS GROUP #
IL0360821818-3Medicaid
ILE95517Medicare UPIN
IL0360821818-3Medicaid
IL1619414OtherBCBS GROUP #