Provider Demographics
NPI:1255638862
Name:RAMON CLIMACO M D S C
Entity type:Organization
Organization Name:RAMON CLIMACO M D S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:U
Authorized Official - Last Name:CLIMACO
Authorized Official - Suffix:
Authorized Official - Credentials:MD,SC
Authorized Official - Phone:217-268-4390
Mailing Address - Street 1:120 S LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:ARCOLA
Mailing Address - State:IL
Mailing Address - Zip Code:61910-1714
Mailing Address - Country:US
Mailing Address - Phone:217-268-4390
Mailing Address - Fax:217-268-4936
Practice Address - Street 1:120 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:ARCOLA
Practice Address - State:IL
Practice Address - Zip Code:61910-1714
Practice Address - Country:US
Practice Address - Phone:217-268-4390
Practice Address - Fax:217-268-4936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13848Medicare UPIN