Individual provider Active NPI

Edgar A. Ramos, PSY.D.

  • Clinical Psychologist
  • Palatine, IL
National Provider Identifier
1205140274
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007888 Issued in IL
Practice address
630 N North CT Ste 180
Palatine, IL 60067-8122
Phone
(708) 525-0291
NPI assigned
Aug 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071007888 IL Primary

Addresses

Primary practice location

630 N North CT Ste 180
Palatine, IL 60067-8122

Mailing address

630 N North CT Ste 180
Palatine, IL 60067-8122
Phone (708) 525-0291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000810 IL Practitioner - Clinical Psychologist 6103085022 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Loretto Hospital CurrentSince Sep 1, 2022 Accepting new patients

Locations

645 S Central Ave
Chicago, IL 60644
Phone (773) 626-4300

Interoperability endpoints

  • Direct secure messaging: edgar.ramos@loretto.medalliesdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1205140274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N NORTH CT STE 180",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678122",
            "telephone_number": "708-525-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N NORTH CT STE 180",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678122",
            "telephone_number": "708-525-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "EDGAR",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-03",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

Verify at the official NPI Registry.