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Individual

DR. EVAN T. MANOLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8760 W 159TH ST, SUITE 204, ORLAND PARK, IL 60462-5395
(708) 873-9600
(708) 873-9607
Mailing address
8760 W 159TH ST, SUITE 204, ORLAND PARK, IL 60462-5395
(708) 873-9600
(708) 873-9607

Taxonomy

Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
036-093168
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036-093168
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036093168
IL
Enumeration date
10/04/2006
Last updated
11/08/2011
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