Provider Demographics
NPI:1528322179
Name:ORTEGA, AMY (CD(DONA), LMT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:CD(DONA), LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4739 N ARTESIAN AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2901
Mailing Address - Country:US
Mailing Address - Phone:312-350-1900
Mailing Address - Fax:
Practice Address - Street 1:4739 N ARTESIAN AVE # 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2901
Practice Address - Country:US
Practice Address - Phone:312-350-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist