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NPI Code Detail

MEDICARE: JONATHAN A ORTIZ PT

MEDICARE: JONATHAN A ORTIZ PT
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
1225100000XPhysical Therapist070011810IL

General Provider Information

NPI Number : 1417151531
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN A ORTIZ PT
Provider Business Mailing Address
First Line : 1432 LONGMEADOW DR
Second Line :
City : GLENVIEW
State : IL
Zip : 60026-1545
Country : US
Telephone Number : 847-730-3540
Fax Number :
Provider Business Practice Location Address
First Line : 700 E EUCLID AVE
Second Line :
City : PROSPECT HEIGHTS
State : IL
Zip : 60070-3409
Country : US
Telephone Number : 847-797-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 12/16/2021

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Directions to “ JONATHAN A ORTIZ PT” Practice Location

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