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Individual

JOANNA Y ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0844
(888) 220-6432
Mailing address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0844
(888) 220-6432

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036091047
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036091047
IL
01
2160743632
BCBS PROVIDER ID
IL
01
440003035
RAILROAD MEDICARE
IL
Enumeration date
09/15/2005
Last updated
11/18/2011
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