Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andres Javier Fantauzzi Portela, MD

Individual provider Dermatology Physician · NPI 1457815086

Andres Javier Fantauzzi Portela, MD is a Dermatology Physician in Chicago, Illinois. Works from 3 locations. Licensed in Illinois and Puerto Rico.

Licensed in
IL, PR
In the registry since
2019
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1950 W Polk St Ste 5210
Chicago, IL 60612-3723
Phone: (312) 864-0200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • F19 Calle Reina Victoria, Guaynabo, PR 00969-5291 — (787) 696-1664
  • 388 Zona Ind Reparada 2, Ponce, PR 00716-2347 — (787) 840-2575

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Dermatology Physician Taxonomy 207N00000X · Licence 23339 (PR)
Dermatology Physician Taxonomy 207N00000X · Licence 125086744 (IL)

Record details

NPI number1457815086
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 28, 2019
Last updated in NPPESJuly 2, 2025
Certification dateJuly 2, 2025

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