Individual
MR. BENITO ORDONEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5966 N MANTON AVE, CHICAGO, IL 60646-5553
(177) 382-2708
(188) 831-6099
Mailing address
5966 N MANTON AVE, CHICAGO, IL 60646-5553
(177) 382-2708
(188) 831-6099
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
O63506080017
IL
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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