Provider Demographics
NPI:1356954663
Name:ORTIZ, NILMA ALEXYNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NILMA
Middle Name:ALEXYNE
Last Name:ORTIZ
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NILMA
Other - Middle Name:ALEXYNE
Other - Last Name:ORTIZ-COLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5632 SANTA BARBARA DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-5437
Mailing Address - Country:US
Mailing Address - Phone:708-692-8687
Mailing Address - Fax:
Practice Address - Street 1:365 LAKE MARIAN RD
Practice Address - Street 2:
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-2096
Practice Address - Country:US
Practice Address - Phone:847-426-4272
Practice Address - Fax:847-426-4336
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20417-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist