Provider Demographics
NPI:1710245568
Name:RAMIREZ, DENISE C
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:C
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16595 W EASTON AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60069-2744
Mailing Address - Country:US
Mailing Address - Phone:224-351-8310
Mailing Address - Fax:
Practice Address - Street 1:16595 W EASTON AVE STE 2A
Practice Address - Street 2:
Practice Address - City:PRAIRIE VIEW
Practice Address - State:IL
Practice Address - Zip Code:60069-2744
Practice Address - Country:US
Practice Address - Phone:224-351-8310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.001527106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist