Individual
SAMANTHA MARIE MANSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4817 W 83RD ST, BURBANK, IL 60459-2790
(708) 966-6241
Mailing address
5716 S RUTHERFORD AVE, CHICAGO, IL 60638-3237
(773) 606-4553
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/26/2024
Last updated
10/26/2024
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