Active NPI
Angelica Ortiz, PSY.D.
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1124182159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Practice address
- 3166 N Lincoln Ave
Suite 304
Chicago, IL 60657-3133 - Phone
- (773) 960-6267
- NPI assigned
- Dec 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | IL | Primary |
Addresses
Primary practice location
3166 N Lincoln Ave
Suite 304
Chicago, IL 60657-3133
Mailing address
3812 N Troy St
Chicago, IL 60618-3427
Phone (773) 960-6267
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071006669 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1124182159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3812 N TROY ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606183427",
"telephone_number": "773-960-6267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3166 N LINCOLN AVE",
"address_2": "SUITE 304",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606573133",
"telephone_number": "773-960-6267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "ANGELICA",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.