Individual
DR. HOSAIN MANESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(123) 456-7890
Mailing address
1775 WEST DEMPSTER, PARK RIDGE, IL 60068
(847) 723-2210
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
125.057918
IL
Other
Enumeration date
03/26/2010
Last updated
09/11/2012
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