Provider Demographics
NPI:1306613252
Name:RAMOS LARDUET, JOSEFINA
Entity type:Individual
Prefix:
First Name:JOSEFINA
Middle Name:
Last Name:RAMOS LARDUET
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 1:1340 REMINGTON RD STE S
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4821
Mailing Address - Country:US
Mailing Address - Phone:872-710-5116
Mailing Address - Fax:773-840-7394
Practice Address - Street 1:2859 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-5095
Practice Address - Country:US
Practice Address - Phone:815-558-9094
Practice Address - Fax:773-840-7394
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.029271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily