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NPI Code Detail

MEDICARE: ROMULO E. ORTEGA MD

MEDICARE: ROMULO E. ORTEGA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician036-067500IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194835389
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROMULO E. ORTEGA MD
Provider Business Mailing Address
First Line : 7702 N ALPINE RD
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-3107
Country : US
Telephone Number : 815-971-2000
Fax Number :
Provider Business Practice Location Address
First Line : 7702 N ALPINE RD
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-3107
Country : US
Telephone Number : 815-971-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 01/29/2010

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Directions to “ ROMULO E. ORTEGA MD” Practice Location

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