Individual
DR. ABBAS MANDVIWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
259 E ERIE ST, CHICAGO, IL 60611-2987
(312) 695-6868
Mailing address
680 N LAKE SHORE DR, CHICAGO, IL 60611-4546
(312) 695-6868
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
036149940
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720433618
NPI
—
Enumeration date
04/27/2016
Last updated
10/21/2019
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