Healthcare Provider Details

I. General information

NPI: 1861195539
Provider Name (Legal Business Name): CARLA ARGENTINA VALENCIA OCHOA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE # MC1052
CHICAGO IL
60637-1443
US

IV. Provider business mailing address

5841 S MARYLAND AVE # MC1052
CHICAGO IL
60637-1443
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-3630
  • Fax: 773-753-8301
Mailing address:
  • Phone: 773-702-3630
  • Fax: 773-753-8301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036.179139
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.179139
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: