Jorge Mantilla, SA-C
Jorge Mantilla, SA-C is a Surgical Assistant in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois and Texas.
- Licensed in
- IL, TX
- In the registry since
- 2019
- Specialties on file
- 2
Practice location Address checks out
5540 N Kimball Ave Apt 3EChicago, IL 60625-4674
Phone: (312) 983-0540
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgical Physician Assistant (primary) | Taxonomy 363AS0400X · Licence 238.000655 (IL) |
|---|---|
| Surgical Assistant | Taxonomy 246ZC0007X · Licence 19-180 (TX) |
Record details
| NPI number | 1962065516 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | SA-C |
| Sole proprietor | Yes |
| NPI enumerated | April 18, 2019 |
| Last updated in NPPES | February 11, 2020 |
| Certification date | February 11, 2020 |
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