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Organization

LUIS M MANGUBAT MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LUIS M MANGUBAT MD (PRESIDENT)
(815) 588-3866
Entity
Organization

Contact information

Practice address
800 BIESTERFIELD RD, SUITE 407, ELK GROVE VILLAGE, IL 60007-3361
(815) 588-3866
(815) 588-3006
Mailing address
800 BIESTERFIELD RD, SUITE 407, ELK GROVE VILLAGE, IL 60007-3361
(815) 588-3866
(815) 588-3006

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
IL

Other

Enumeration date
07/31/2007
Last updated
09/06/2023
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