Individual
DR. KUNAL MANDAVAWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
41 MALL RD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036159885
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
TP033
KY
390200000X
Student in an Organized Health Care Education/Training Program
276430
MA
Other
Enumeration date
06/21/2018
Last updated
05/13/2026
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