Individual
JENNIFER MANDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1535 LAKE COOK RD, 112, NORTHBROOK, IL 60062-1447
(312) 909-6343
Mailing address
401 HUEHL RD, 2A, NORTHBROOK, IL 60062-2300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2137912
IL
Other
Enumeration date
08/01/2014
Last updated
08/01/2014
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