Individual
KELLY ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-PHMNP-BC
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2540
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
692485
NY
163W00000X
Registered Nurse
95104478
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209016279
IL
Other
Enumeration date
07/15/2015
Last updated
06/21/2022
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