Individual
JONATHAN DOUGLAS MANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
781 S MCHENRY AVE STE B, CRYSTAL LAKE, IL 60014-7444
(815) 459-2200
Mailing address
781 S MCHENRY AVE STE B, CRYSTAL LAKE, IL 60014-7444
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.028686
IL
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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