Provider Demographics
NPI:1588207716
Name:RAMOS, JASMIN LUISA (MSW)
Entity Type:Individual
Prefix:MISS
First Name:JASMIN
Middle Name:LUISA
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E 103RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-2807
Mailing Address - Country:US
Mailing Address - Phone:773-371-3600
Mailing Address - Fax:773-371-3699
Practice Address - Street 1:235 E 103RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-2807
Practice Address - Country:US
Practice Address - Phone:773-371-3600
Practice Address - Fax:773-371-3699
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILR52043292971101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health