Individual
MANFRED P. MAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1445 N HUNT CLUB RD, SUITE 304, GURNEE, IL 60031-2603
(847) 588-0100
Mailing address
701 LEE ST, SUITE 300, DES PLAINES, IL 60016-4539
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036083233
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036083233
—
IL
Enumeration date
03/23/2006
Last updated
06/28/2013
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