Individual
MRS. CHONA G MANABAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
24922 EMERALD AVE, PLAINFIELD, IL 60585-2968
(815) 272-4563
(815) 436-3848
Mailing address
24922 EMERALD AVE, PLAINFIELD, IL 60585-2968
(815) 272-4563
(815) 436-3848
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
70011748
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039941191
BCBS PROVIDER #
IL
Enumeration date
08/05/2006
Last updated
07/08/2007
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