Organization
MANUEL CESAR IGLESIAS, M.D., S.C.
Active
Organization
MANUEL CESAR IGLESIAS, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL C. IGLESIAS M.D. (PRESIDENT)
(847) 967-1149
Entity
Organization
Contact information
Practice address
1111 SUPERIOR ST, SUITE 409, MELROSE PARK, IL 60160-4138
(708) 681-0070
Mailing address
8135 N MILWAUKEE AVE, NILES, IL 60714-2828
(847) 967-1149
(847) 967-8594
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21607825
BLUE SHIELD OF ILLINOIS
IL
Enumeration date
06/01/2006
Last updated
10/01/2007
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