Healthcare Provider Details

I. General information

NPI: 1710564323
Provider Name (Legal Business Name): CESAR JOSE OROPEZA MOTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2021
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 S WESTERN AVE STE 205
CHICAGO IL
60608-2503
US

IV. Provider business mailing address

3134 N CLARK ST
CHICAGO IL
60657-4414
US

V. Phone/Fax

Practice location:
  • Phone: 773-584-6200
  • Fax: 312-766-4925
Mailing address:
  • Phone: 312-766-4949
  • Fax: 312-766-4925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.172133
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: