Individual
MARIO ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3450 S ARCHER AVE, CHICAGO, IL 60608-6837
(773) 523-1000
Mailing address
3603 W 53RD ST APT 5, CHICAGO, IL 60632-3757
(773) 954-6812
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
02/12/2025
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