Provider Demographics
NPI:1790750412
Name:RAMIREZ, MARIA L (OTR L)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:ROCKDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60436
Mailing Address - Country:US
Mailing Address - Phone:815-744-0221
Mailing Address - Fax:815-744-0221
Practice Address - Street 1:709 MARGARET ST
Practice Address - Street 2:
Practice Address - City:ROCKDALE
Practice Address - State:IL
Practice Address - Zip Code:60436
Practice Address - Country:US
Practice Address - Phone:815-744-0221
Practice Address - Fax:815-744-0221
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932370OtherBCBS