Individual
JENAL ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2816 N KOSTNER AVE, CHICAGO, IL 60641-5345
(773) 474-3525
Mailing address
609 S FELL AVE APT 1, NORMAL, IL 61761-3685
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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