Individual
DENNIS TAKAMI MANSHIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2907 S WABASH AVE STE 100A, CHICAGO, IL 60616-3271
(773) 477-3699
(312) 877-5049
Mailing address
2907 S WABASH AVE STE 100A, CHICAGO, IL 60616-3271
(773) 477-3699
(773) 477-0624
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036065850
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036065850
—
IL
Enumeration date
03/03/2007
Last updated
11/12/2024
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