Individual
BRYAN BANUELOS RAMIREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
219 W CHICAGO AVE STE 200, CHICAGO, IL 60654-5600
(872) 777-8110
Mailing address
861 RIDGE RD, HOMEWOOD, IL 60430-2020
(708) 543-3901
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/23/2025
Last updated
09/29/2025
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