Provider Demographics
NPI:1861429409
Name:ABREU-RAMOS, ANTONIO M (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:M
Last Name:ABREU-RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ANTONIO
Other - Middle Name:M
Other - Last Name:ABREU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:401 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4264
Mailing Address - Country:US
Mailing Address - Phone:312-635-0973
Mailing Address - Fax:
Practice Address - Street 1:1 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-7016
Practice Address - Country:US
Practice Address - Phone:410-574-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0076607.208100000X
PR15909208100000X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD355151ZHDRMedicare PIN