Provider Demographics
NPI:1508882846
Name:FLORES, RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 N MOZART ST STE 404
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2790
Mailing Address - Country:US
Mailing Address - Phone:773-292-8278
Mailing Address - Fax:773-292-5944
Practice Address - Street 1:1044 N MOZART ST STE 404
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2790
Practice Address - Country:US
Practice Address - Phone:773-292-8334
Practice Address - Fax:773-292-5944
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD16333Medicare UPIN