Individual
COLE ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
717 N 11TH AVE, MELROSE PARK, IL 60160-4113
(925) 285-2672
Mailing address
717 N 11TH AVE, MELROSE PARK, IL 60160-4113
(925) 285-2672
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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