Provider Demographics
NPI:1962738914
Name:RAMOS, FILIMON (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:FILIMON
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 59
Mailing Address - Street 2:1313 W. CHICAGO AVE
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-0059
Mailing Address - Country:US
Mailing Address - Phone:219-397-1196
Mailing Address - Fax:219-392-4958
Practice Address - Street 1:1313 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3316
Practice Address - Country:US
Practice Address - Phone:219-397-1196
Practice Address - Fax:219-392-4958
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001098A363A00000X
IL085-003731363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant