Provider Demographics
NPI:1265542260
Name:RAMIREZ-DOLLETON, RACQUEL NORADA V (MD)
Entity type:Individual
Prefix:DR
First Name:RACQUEL
Middle Name:NORADA
Last Name:RAMIREZ-DOLLETON
Suffix:V
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RACQUEL
Other - Middle Name:NORADA
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:781 MCHENRY AVE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7444
Mailing Address - Country:US
Mailing Address - Phone:815-459-2200
Mailing Address - Fax:815-459-0556
Practice Address - Street 1:781 MCHENRY AVE
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7444
Practice Address - Country:US
Practice Address - Phone:815-459-2200
Practice Address - Fax:815-459-0556
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090114207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine