Provider Demographics
NPI:1245757996
Name:CRESPO RAMOS, SUSANNE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:SUSANNE
Middle Name:MARIE
Last Name:CRESPO RAMOS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:180 HARVESTER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6686
Mailing Address - Country:US
Mailing Address - Phone:773-702-1150
Mailing Address - Fax:
Practice Address - Street 1:TORRE MEDICA 1 DR. PEDRO BLANCO LUGO 220 CARR.2
Practice Address - Street 2:SUITE 316
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-2445
Practice Address - Fax:787-854-2636
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.163959207ZP0102X
PR22783207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology