Individual
CARLOS DAVID ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5140 N CALIFORNIA AVE, SUITE 780, CHICAGO, IL 60625-3645
(773) 235-8887
(773) 235-8882
Mailing address
5140 N CALIFORNIA AVE, SUITE 780, CHICAGO, IL 60625-3645
(773) 235-8887
(773) 235-8882
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036100042
IL
2086S0102X
Surgical Critical Care Physician
036100042
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-100042
—
IL
01
—
1629966
BCBSIL NIESS
IL
01
—
1630046
BSBSIL BSG
IL
01
—
K26864
INDIVIDUAL MEDICARE ID
IL
Enumeration date
07/24/2006
Last updated
09/20/2023
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