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Organization

FABIO ORTEGA MD SC

Active
Other names
FABIO ORTEGA MD SC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FABIO ORTEGA MD (PRESIDENT)
(847) 679-3200
Entity
Organization

Contact information

Practice address
9933 LAWLER AVE, SUITE 409, SKOKIE, IL 60077
(847) 679-3200
(847) 679-4631
Mailing address
9933 LAWLER AVE, SUITE 409, SKOKIE, IL 60077
(847) 679-3200
(847) 679-4631

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036065413
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
336029781
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036065413
IL
01
31601691
BCBS OF ILLINOIS
IL
Enumeration date
10/07/2008
Last updated
03/25/2009
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