Healthcare Provider Details

I. General information

NPI: 1255529640
Provider Name (Legal Business Name): DEBORAH LOUISE ORTIZ ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E SCHILLER ST SUITE 318
ELMHURST IL
60126-2858
US

IV. Provider business mailing address

110 E SCHILLER ST SUITE 318
ELMHURST IL
60126-2858
US

V. Phone/Fax

Practice location:
  • Phone: 630-832-1775
  • Fax: 630-832-3078
Mailing address:
  • Phone: 630-832-1775
  • Fax: 630-832-3078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: