Individual
MICHAEL GREGORY MANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-5446
Mailing address
143 CORNWALL AVE, TONAWANDA, NY 14150-8513
(716) 418-2562
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125068105
IL
Other
Enumeration date
03/27/2016
Last updated
06/08/2016
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