Individual
DR. DANY MAMOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 E CHICAGO RD, STURGIS, MI 49091-8524
(269) 659-6747
(269) 659-6746
Mailing address
15 S MCHENRY RD, BUFFALO GROVE, IL 60089-6705
(847) 459-6100
(847) 541-4857
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036142021
IL
207Q00000X
Family Medicine Physician
Primary
4301100135
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036142021
STATE LICENSE
IL
Enumeration date
07/31/2009
Last updated
05/05/2021
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