Individual
RAMON MANGLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2320 HIGH ST, BLUE ISLAND, IL 60406-2426
(708) 388-5500
(708) 388-5672
Mailing address
PO BOX 720, CHICAGO, IL 60690-0720
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036079265
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020036556
RAILROAD MEDICARE
IL
05
—
036079265
—
IL
01
—
324350
LOCALITY 16
IL
01
—
IL3596004
LOCALITY 15
IL
Enumeration date
04/17/2006
Last updated
08/10/2023
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