Individual
KAIF MOHAMMED YUSUF MANSURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1006 S DIVISION ST, CARTERVILLE, IL 62918
(618) 519-9200
(618) 985-3774
Mailing address
109 CALIFORNIA ST, PO BOX 577, CARTERVILLE, IL 62918-0577
(618) 519-9200
(618) 985-4635
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036145712
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036145712
—
IL
Enumeration date
06/16/2015
Last updated
12/10/2020
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