MEDICARE: ARIELLE ORDONEZ DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070021492	IL

General Provider Information

NPI Number	:	1336503887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIELLE ORDONEZ DPT

Provider Business Mailing Address
First Line	:	1011 N WOLCOTT AVE # 1N
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-3760
Country	:	US
Telephone Number	:	224-436-1904
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 N WOLCOTT AVE # 1N
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-3760
Country	:	US
Telephone Number	:	224-436-1904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2016
Last Update Date	:	11/03/2022

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Directions to “ ARIELLE ORDONEZ DPT” Practice Location

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