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General NPI Number Information
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NPI Number | 1972525269
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Entity Type | Individual
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Provider Name | CARLOS DAVID ORTEGA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 5140 N CALIFORNIA AVE SUITE 780
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City | CHICAGO
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State | IL
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Zip | 60625-3645
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Country | US
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Telephone | 773-235-8887
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Fax | 773-235-8882
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Provider Business Mailing Address
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Address Line | 5140 N CALIFORNIA AVE SUITE 780
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City | CHICAGO
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State | IL
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Zip | 60625-3645
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Country | US
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Telephone | 773-235-8887
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Fax | 773-235-8882
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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 | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 036100042
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036100042
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License Number State | IL
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