Provider Demographics
NPI:1700647336
Name:RATCLIFF, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:RATCLIFF
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 1:260 S ADDISON ST
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-2624
Mailing Address - Country:US
Mailing Address - Phone:312-912-2716
Mailing Address - Fax:
Practice Address - Street 1:260 S ADDISON ST
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-2624
Practice Address - Country:US
Practice Address - Phone:312-912-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant