Organization
HOWARD S MANGURTEN MDSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD SHELDON MANGURTEN MD (PRESIDENT)
(847) 884-8420
Entity
Organization
Contact information
Practice address
990 GRAND CANYON PARKWAY, SUITE 310, HOFFMAN ESTATES, IL 60169
(847) 884-8420
(847) 884-0198
Mailing address
990 GRAND CANYON PARKWAY, SUITE 310, HOFFMAN ESTATES, IL 60169
(847) 884-8420
(847) 884-0198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01628148
BCBS
IL
01
—
1003990870
NPI
—
01
—
1417055765
NPI
—
01
—
31603504
BCBS
IL
Enumeration date
02/08/2007
Last updated
02/12/2008
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