Individual provider Active NPI

Adnybel Rosario-Ortiz, M.D.

  • Pediatrics Physician
  • Waukegan, IL
National Provider Identifier
1336295195
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036127634 Issued in IL
Practice address
2323 Grand Ave
Waukegan, IL 60085-3312
Phone
(847) 666-3494
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036127634 IL Primary

Addresses

Primary practice location

2323 Grand Ave
Waukegan, IL 60085-3312

Mailing address

2323 Grand Ave
Waukegan, IL 60085-3312
Phone (847) 666-3494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110804000434 IL Practitioner - Pediatric Medicine 1052580271 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036127634ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center, Inc CurrentSince Nov 21, 2018 Accepting new patients
Erie Family Health Center Inc CurrentSince Nov 21, 2018 Accepting new patients

Locations

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

251 E Huron St
Chicago, IL 60611

1504 S Albany Ave
Chicago, IL 60623

2323 Grand Ave
Waukegan, IL 60085
Phone (847) 666-2427

Interoperability endpoints

  • Direct secure messaging: arosarioortiz368168@direct.ochin.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1336295195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600853312",
            "telephone_number": "847-666-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600853312",
            "telephone_number": "847-666-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO-ORTIZ",
        "first_name": "ADNYBEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036127634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.