Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 48693102 | TX |
NPI | 1538458955 |
---|---|
Provider Name | Ramon Cortes |
First Address | Chicago, IL 60651-1046 |
Second Address | Chicago, IL 60651-1046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 07/04/2011 |