Provider Demographics
NPI:1760593503
Name:RAMOS, BENEDICTA E (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BENEDICTA
Middle Name:E
Last Name:RAMOS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 N MONITOR AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651
Mailing Address - Country:US
Mailing Address - Phone:773-378-2754
Mailing Address - Fax:
Practice Address - Street 1:1725 W HARRISON
Practice Address - Street 2:SUITE 408 WEST
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-997-2229
Practice Address - Fax:312-666-4163
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1616020OtherBC/BS