Individual
MIGUEL ANGEL ORTIZ RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 N 1ST, SUITE D308, SPRINGFIELD, IL 62702
(217) 545-4401
(217) 545-1793
Mailing address
P. O. BOX 19638, SPRINGFIELD, IL 62794-9638
(217) 545-4401
(217) 545-1793
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125080748
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/07/2020
Last updated
06/26/2022
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