Individual
DORALIS CORIANO ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1300 W BELMONT AVE STE 300, CHICAGO, IL 60657-3200
(773) 880-1310
Mailing address
661 W LAKE ST STE 2S, CHICAGO, IL 60661-1034
(773) 389-4747
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.013997
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362235165
—
IL
Enumeration date
08/31/2016
Last updated
07/27/2022
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