Provider Demographics
NPI:1336503887
Name:ORDONEZ, ARIELLE (DPT)
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:ORDONEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N WOLCOTT AVE # 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3760
Mailing Address - Country:US
Mailing Address - Phone:224-436-1904
Mailing Address - Fax:
Practice Address - Street 1:1011 N WOLCOTT AVE # 1N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3760
Practice Address - Country:US
Practice Address - Phone:224-436-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070021492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist