Provider Demographics
NPI:1386922466
Name:ORTEZA, RHEA DIVINA LO (DPT, CEEAA)
Entity type:Individual
Prefix:
First Name:RHEA DIVINA
Middle Name:LO
Last Name:ORTEZA
Suffix:
Gender:F
Credentials:DPT, CEEAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 SHERWOOD GLN
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IL
Mailing Address - Zip Code:61356-2848
Mailing Address - Country:US
Mailing Address - Phone:917-602-5051
Mailing Address - Fax:
Practice Address - Street 1:2649 E 75TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3835
Practice Address - Country:US
Practice Address - Phone:773-356-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-24
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist