Individual
DR. JUAN GABRIEL ORTIZ-VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE BLDG 105, MAYWOOD, IL 60153-3328
(708) 216-6462
(708) 216-1249
Mailing address
1342 W CULLERTON ST APT 3, CHICAGO, IL 60608-3114
(787) 485-0817
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
125.079321
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2022
Last updated
05/26/2022
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