Individual
DR. LUCIANO ORTA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 759-3100
(815) 363-9094
Mailing address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 759-3100
(815) 363-9094
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036084476
IL
207P00000X
Emergency Medicine Physician
47498-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036084476 2
—
IL
05
—
1346353505
—
WI
01
—
ORTALUC
MERCYCARE INSURANCE
WI
Enumeration date
08/15/2006
Last updated
05/03/2021
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