Mantilla, Jorge

Mantilla, Jorge is an sole proprietor health care provider with primary practice located at 5540 N Kimball Ave Apt 3E , Chicago IL 60625-4674. He recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Surgical Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Mantilla, Jorge can be contacted via phone (312) 983-0540.

Contact Information

Primary practice address
5540 N Kimball Ave Apt 3E Chicago IL 60625-4674
Phone: (312) 983-0540
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant 246ZC0007X 19-180 Texas
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 238.000655 Illinois

Profile Details

NPI number 1962065516
LBN Legal business name Mantilla, Jorge
Credentials SA-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 18th, 2019
Last updated Feb 11th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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