Provider Demographics
NPI:1124341458
Name:RAMJAC CORP INC
Entity type:Organization
Organization Name:RAMJAC CORP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:CANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-559-9345
Mailing Address - Street 1:1015 WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3636
Mailing Address - Country:US
Mailing Address - Phone:847-559-9345
Mailing Address - Fax:847-559-9225
Practice Address - Street 1:2530 CRAWFORD AVE STE 104
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4954
Practice Address - Country:US
Practice Address - Phone:847-559-9345
Practice Address - Fax:847-559-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360552322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty