Provider Demographics
NPI:1346941135
Name:SANCHEZ, TIFFANY ANN ORTEGA (RN)
Entity Type:Individual
Prefix:
First Name:TIFFANY ANN
Middle Name:ORTEGA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TIFFANY ANN
Other - Middle Name:FLORES
Other - Last Name:ORTEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3001 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064-3048
Mailing Address - Country:US
Mailing Address - Phone:224-610-7698
Mailing Address - Fax:224-610-7613
Practice Address - Street 1:3001 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3048
Practice Address - Country:US
Practice Address - Phone:224-610-7698
Practice Address - Fax:224-610-7613
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95249440163WW0101X
IL041516385163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory