Healthcare Provider Details

I. General information

NPI: 1033024518
Provider Name (Legal Business Name): JOCELYN ORTIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4431 GAGE AVE
LYONS IL
60534-1929
US

IV. Provider business mailing address

5243 S KOSTNER AVE
CHICAGO IL
60632-4622
US

V. Phone/Fax

Practice location:
  • Phone: 708-734-4700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number1247425
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: