Provider Demographics
NPI:1578180147
Name:ORTIZII PC
Entity Type:Organization
Organization Name:ORTIZII PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:312-782-7833
Mailing Address - Street 1:111 N WABASH AVE STE 1111
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3119
Mailing Address - Country:US
Mailing Address - Phone:312-782-7833
Mailing Address - Fax:312-236-0783
Practice Address - Street 1:111 N WABASH AVE STE 1111
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3119
Practice Address - Country:US
Practice Address - Phone:312-782-7833
Practice Address - Fax:312-236-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty