Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JORGE MANTILLA, SA-C
Active Sole ProprietorJORGE MANTILLA, SA-C is a Surgical Physician Assistant healthcare provider located in CHICAGO, Illinois. NPI 1962065516 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · CHICAGO, IL
Registration Details
- NPI Number
- 1962065516
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 18, 2019 (7.2830419111298 yrs)
- Last Updated
- Feb 11, 2020
- Licenses
-
19-180 (TX)238.000655 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5540 N KIMBALL AVE APT 3ECHICAGO, IL, 606254674Browse IL providers · Browse ZIP 60625
- Phone
- 3129830540
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Other Surgical Physician Assistant Providers in CHICAGO, IL
| Name | Credential | NPI |
|---|---|---|
| JOHN D GNEZDA | — | 1295722296 |
| MRS. SHANA JOHNSON | PA-C | 1346237492 |
| MR. ROBERT F THOMANN | PA-C | 1114914199 |
| MASIHUDDIN SYED QUADRI | — | 1467434340 |
| MR. EMIL ORPILLA | PA-C | 1902880248 |
| JENNIFER MARIE OROZCO | PA-C | 1396715017 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.