Healthcare Provider Details

I. General information

NPI: 1982379400
Provider Name (Legal Business Name): ARACELI ORTIZ OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20841 W BROCKTON CT
PLAINFIELD IL
60544-9572
US

IV. Provider business mailing address

20841 W BROCKTON CT
PLAINFIELD IL
60544-9572
US

V. Phone/Fax

Practice location:
  • Phone: 773-949-4402
  • Fax:
Mailing address:
  • Phone: 773-949-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: