Provider Demographics
NPI:1194446641
Name:ORTEGA-MARQUEZ, SERGIO (DC)
Entity type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:
Last Name:ORTEGA-MARQUEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60526-1968
Mailing Address - Country:US
Mailing Address - Phone:708-354-9599
Mailing Address - Fax:
Practice Address - Street 1:442 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60526-1968
Practice Address - Country:US
Practice Address - Phone:708-354-9599
Practice Address - Fax:708-354-9799
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty