Individual
DR. SAMUEL RAMIREZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
5723 W FULLERTON AVE, CHICAGO, IL 60639-2306
(773) 622-8060
(773) 622-8095
Mailing address
4918 N MAGNOLIA AVE, CHICAGO, IL 60640-3507
(773) 728-0989
(773) 728-1062
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004751
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004751
—
IL
01
—
01607718
BLUE CROSS BLUE SHIELD
IL
01
—
480027231
RAILROAD MEDICARE
IL
Enumeration date
05/01/2006
Last updated
07/08/2007
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