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

Jorge Mantilla, SA-C

Individual provider Surgical Assistant · NPI 1962065516

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 3E
Chicago, IL 60625-4674
Phone: (312) 983-0540
Show map & directions

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 number1962065516
Entity typeIndividual (Type 1)
GenderMale
Credentials SA-C
Sole proprietorYes
NPI enumeratedApril 18, 2019
Last updated in NPPESFebruary 11, 2020
Certification dateFebruary 11, 2020

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