Individual
ANTONIO MARIA RAMIREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 N MAIN ST, PRINCETON, IL 61356-1785
(815) 875-6001
(815) 875-3612
Mailing address
130 N MAIN ST, PO BOX 372, PRINCETON, IL 61356-1785
(815) 875-6001
(815) 875-3612
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036075824
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00600116
BLUE CROSS BLUE SHIELD
IL
05
—
036075824
—
IL
01
—
1023186517
ORGANIZATION IDENTIFIER #
—
Enumeration date
07/19/2006
Last updated
07/08/2007
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