Individual
DORIAN ORTEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2657 W DIVISION ST, CHICAGO, IL 60622-2851
(773) 469-0709
Mailing address
1711 W JARVIS AVE APT 306, CHICAGO, IL 60626-7616
(773) 469-0709
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
180.010759
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164837282
—
IL
Enumeration date
06/26/2014
Last updated
04/15/2021
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