Organization
MANI N SUBRAMANIAN MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANI N SUBRAMANIAN MD (OWNER)
(847) 391-9877
Entity
Organization
Contact information
Practice address
150 N RIVER RD, SUITE 240, DES PLAINES, IL 60016-1272
(847) 391-9877
(847) 391-9177
Mailing address
1872 BIG BEND DR, DES PLAINES, IL 60016-3517
(847) 640-0513
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036058679
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058679
—
IL
Enumeration date
12/21/2006
Last updated
07/01/2008
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