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General NPI Number Information
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NPI Number | 1396715017
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Entity Type | Individual
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Provider Name | JENNIFER MARIE OROZCO PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST SUITE#1156
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-563-2109
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Fax | 312-563-4388
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Provider Business Mailing Address
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Address Line | 600 S PAULINA ST 761 AAC
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City | CHICAGO
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State | IL
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Zip | 60612-3806
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Country | US
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Telephone | 312-942-5407
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Fax | 312-563-2805
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 85-002136
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License Number State | IL
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