Provider Demographics
NPI:1487423810
Name:ORTIZ, SAVANNAH PAULINE (LCSW, PEL)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:PAULINE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LCSW, PEL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2679 N BURLING ST APT CH
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1585
Mailing Address - Country:US
Mailing Address - Phone:217-550-4734
Mailing Address - Fax:
Practice Address - Street 1:6843 STANLEY AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-5292
Practice Address - Country:US
Practice Address - Phone:708-691-3538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0262531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical