Jake Portillo, MD is a
Student In An Organized Health Care Education/training Program physician based in Wheaton, Illinois. Jake Portillo is licensed to practice in * (Not Available) (license number ) and his current practice location is 26w171 Roosevelt Rd, Wheaton, Illinois. He can be reached at his office (for appointments etc.) via phone at
(630) 909-8000.
NPI number for Jake Portillo is 1710567110 and his current mailing address is 1500 S Main St, Fort Worth, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710567110.
Physician's Profile
| Full Name | Jake Portillo |
|---|
| Gender | Male |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 26w171 Roosevelt Rd, Wheaton, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1710567110
- Provider Enumeration Date: 04/09/2021
- Last Update Date: 09/29/2022
Medical Identifiers
Medical identifiers for Jake Portillo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710567110 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 125080756 (Illinois) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jake Portillo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jake Portillo, MD
1500 S Main St,
Fort Worth, TX 76104-4917
Ph: (817) 702-1244 | Jake Portillo, MD
26w171 Roosevelt Rd,
Wheaton, IL 60187-6002
Ph: (630) 909-8000 |
Reviews and Comments