ANDRES JAVIER FANTAUZZI PORTELA MD
NPI 1457815086
Student in an Organized Health Care Education/Training Program in Chicago, IL

Q: What is Andres Fantauzzi Portela's NPI number?

The NPI number for Andres Fantauzzi Portela is 1457815086. It was assigned to this individual provider in the NPPES registry on January 28, 2019.

Q: What is Andres Fantauzzi Portela's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since January 28, 2019

1950 W POLK ST STE 5210, CHICAGO, IL 60612(312) 864-0200 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 2, 2025, Jul 2, 2024, Dec 5, 2023 and 1 more (4 updates tracked since 2019).

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About Andres Javier Fantauzzi Portela Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDRES JAVIER FANTAUZZI PORTELA MD (NPI 1457815086) is an individual student in an organized health care education/training program in Chicago, Illinois and active in the NPI registry since January 2019. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1457815086

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameANDRES JAVIER FANTAUZZI PORTELACredential: MD

Location Address1950 W POLK ST STE 5210Chicago, IL 60612-3723

Mailing Address1950 W Polk St Ste 5210Chicago, IL 60612-3723 · (312) 864-0200

Phone(312) 864-0200

Sole ProprietorNo

Enumeration DateJanuary 28, 2019

Last NPPES UpdateJuly 2, 20254 updates tracked since enumeration

NPPES CertifiedJuly 2, 2025

✔ NPI 1457815086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedDermatologyTaxonomy 207N00000X · License 23339 (PR), 125086744 (IL)

1950 W POLK ST STE 5210, Chicago, IL 60612

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Secondary Practice Locations 2

Location 1388 Zona Ind Reparada 2Ponce, PR 00716-2347 · Phone (787) 840-2575

Location 2F19 Calle Reina VictoriaGuaynabo, PR 00969-5291 · Phone (787) 696-1664

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMILEHIN MERCY JEGEDE MD

Student in an Organized Health Care Education/Training Program