Individual
JUAN RAFAEL MENDOZA ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3024 E EMPIRE ST FL 3, BLOOMINGTON, IL 61704-5402
(309) 556-7700
(309) 556-7775
Mailing address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036175617
IL
Other
Enumeration date
07/24/2018
Last updated
02/19/2026
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