MEDICARE: DR. IRMA I ORTIZ-ARROYO 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
1	208000000X	Pediatrics Physician	R6H69	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1285627356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRMA I ORTIZ-ARROYO MD

Provider Business Mailing Address
First Line	:	PO BOX 7412065
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-2065
Country	:	US
Telephone Number	:	314-849-3320
Fax Number	:	314-849-7766

Provider Business Practice Location Address
First Line	:	4850 LEMAY FERRY RD
Second Line	:	STE 120
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-1526
Country	:	US
Telephone Number	:	314-849-3320
Fax Number	:	314-849-7766

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	04/18/2025

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