Individual
DR. ANDREW GENE MANTELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
704 PINTAIL CT, DEERFIELD, IL 60015-3645
(847) 219-9600
Mailing address
704 PINTAIL CT, DEERFIELD, IL 60015-3645
(847) 219-9600
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04926447
BCBS
IL
Enumeration date
01/24/2007
Last updated
07/08/2007
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