JORGE MANTILLA SA-C
NPI 1962065516
Physician Assistant - Surgical in Chicago, IL

Q: What is Jorge Mantilla's NPI number?

The NPI number for Jorge Mantilla is 1962065516. It was assigned to this individual provider in the NPPES registry on April 18, 2019.

Q: What is Jorge Mantilla's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Jorge Mantilla was last updated on February 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 18, 2019

5540 N KIMBALL AVE APT 3E, CHICAGO, IL 60625(312) 983-0540 Get Directions Write a Review

NPPES record last updated: February 11, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 11, 2020, Apr 18, 2019 (2 updates tracked since 2019).

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About Jorge Mantilla Sa-c NPPES

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

JORGE MANTILLA SA-C (NPI 1962065516) is an individual surgical provider in Chicago, Illinois, licensed in Illinois (238.000655) and active in the NPI registry since April 2019.

NPPES Registry Identity

NPI1962065516

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameJORGE MANTILLACredential: SA-C

Location Address5540 N KIMBALL AVE APT 3EChicago, IL 60625-4674

Mailing Address5540 N Kimball Ave Apt 3eChicago, IL 60625-4674 · (312) 983-0540

Phone(312) 983-0540

Sole ProprietorYes

Enumeration DateApril 18, 2019

Last NPPES UpdateFebruary 11, 20202 updates tracked since enumeration

✔ NPI 1962065516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in IL · 238.000655

Also ListedSpecialist/Technologist, Other · Surgical AssistantTaxonomy 246ZC0007X · License 19-180 (TX)

5540 N KIMBALL AVE APT 3E, Chicago, IL 60625

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jorge Mantilla's NPI number?

The NPI number for Jorge Mantilla is 1962065516. It was assigned to this individual provider in the NPPES registry on April 18, 2019.

Where is Jorge Mantilla located?

Jorge Mantilla practices at 5540 N Kimball Ave Apt 3E, Chicago, IL 60625. The listed phone number is (312) 983-0540.

What is Jorge Mantilla's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Jorge Mantilla was last updated on February 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.