Individual
MRS. JACQUELINE M MONDJI MAMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1475 BASSWOOD DR, BOLINGBROOK, IL 60490-5419
(630) 759-4232
(630) 759-0327
Mailing address
1475 BASSWOOD DR, BOLINGBROOK, IL 60490-5419
(630) 759-4232
(630) 759-0327
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
12/02/2009
Last updated
12/02/2009
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