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Individual
MRS. MARY MCMANUS
Active
Individual
MRS. MARY MCMANUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
277002750
IL
363LF0000X
Family Nurse Practitioner
Primary
209005389
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209005389
LICENSE
IL
Enumeration date
08/25/2006
Last updated
03/21/2025
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