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NPI Code Detail

MEDICARE: LIDIA J ORTIZ-RITCHEY APN

MEDICARE: LIDIA J ORTIZ-RITCHEY APN
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
1363LP2300XPrimary Care Nurse Practitioner209012036041364106IL
2363L00000XNurse Practitioner209012036IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F400213130OTHERMEDICARE PTAN

General Provider Information

NPI Number : 1710365085
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIDIA J ORTIZ-RITCHEY APN
Provider Business Mailing Address
First Line : 539 N DEARBORN ST
Second Line :
City : CHICAGO
State : IL
Zip : 60654-4812
Country : US
Telephone Number : 312-549-4400
Fax Number :
Provider Business Practice Location Address
First Line : 539 N DEARBORN ST
Second Line :
City : CHICAGO
State : IL
Zip : 60654-4812
Country : US
Telephone Number : 312-549-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2015
Last Update Date : 01/03/2024

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