Healthcare Provider Details

I. General information

NPI: 1477472215
Provider Name (Legal Business Name): LIDIA ALEXANDRA MONTOYA ORTIZ LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10081 W LINCOLN HWY
FRANKFORT IL
60423-1272
US

IV. Provider business mailing address

10081 W LINCOLN HWY
FRANKFORT IL
60423-1272
US

V. Phone/Fax

Practice location:
  • Phone: 815-313-2100
  • Fax: 815-345-3177
Mailing address:
  • Phone: 815-313-2100
  • Fax: 815-345-3177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150118651
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: