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Individual
MARISA S AGUILA-MANALO
Active
Individual
MARISA S AGUILA-MANALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036068818
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632143
BCBS
IL
05
—
036068818
—
IL
Enumeration date
10/21/2005
Last updated
10/10/2011
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