Organization
MANGAHAS MEDICAL CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYLENE MANGAHAS MD (PRESIDENT)
(219) 397-6903
Entity
Organization
Contact information
Practice address
521 W CHICAGO AVE, EAST CHICAGO, IN 46312-3206
(219) 397-6903
Mailing address
521 W CHICAGO AVE, EAST CHICAGO, IN 46312-3206
(219) 397-6903
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
01045012A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000280536
ANTHEM
IN
01
—
0005078527
AETNA
IN
01
—
0090000883
BCBS OF ILLINOIS
IL
Enumeration date
08/22/2006
Last updated
08/22/2020
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