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NPI Code Detail

MEDICARE: ROBERT ORTEGA MD

MEDICARE: ROBERT 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
12085R0202XDiagnostic Radiology Physician30223AZ
22085R0202XDiagnostic Radiology Physician036104576IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1271083OTHERAZVRL
2698516OTHERAZAHCCCS

General Provider Information

NPI Number : 1730178781
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT ORTEGA MD
Provider Business Mailing Address
First Line : 6830 E IRONWOOD DR
Second Line :
City : PARADISE VALLEY
State : AZ
Zip : 85253-2655
Country : US
Telephone Number : 480-443-9391
Fax Number : 480-443-9390
Provider Business Practice Location Address
First Line : 4201 W MEDICAL CENTER DR
Second Line :
City : MCHENRY
State : IL
Zip : 60050-8409
Country : US
Telephone Number : 815-334-5566
Fax Number : 815-759-4008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 11/08/2023

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