Individual
ELIE KHADR MANGOUBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
405 N WABASH AVE, 3805, CHICAGO, IL 60611-3591
(312) 787-7865
Mailing address
1000 N LAKE SHORE PLZ, 26C, CHICAGO, IL 60611-1354
(312) 787-7865
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Enumeration date
05/09/2006
Last updated
11/01/2007
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