Provider Demographics
NPI:1538189600
Name:RAMIREZ, SAUL FABIAN (ATC)
Entity type:Individual
Prefix:MR
First Name:SAUL
Middle Name:FABIAN
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E WOODLAWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-2265
Mailing Address - Country:US
Mailing Address - Phone:815-485-5838
Mailing Address - Fax:
Practice Address - Street 1:2848 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-1167
Practice Address - Country:US
Practice Address - Phone:815-436-1444
Practice Address - Fax:815-436-9814
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer