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Individual

DR. LUIS M MANGUBAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., S.C.

Contact information

Practice address
800 BIESTERFIELD RD, SUITE 407, ELK GROVE VILLAGE, IL 60007-3361
(815) 588-3866
(815) 588-3006
Mailing address
800 BIESTERFIELD RD, SUITE 407, ELK GROVE VILLAGE, IL 60007-3378
(815) 588-3866
(815) 588-3006

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
IL

Other

Enumeration date
01/22/2007
Last updated
02/28/2008
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