Individual
DR. JESUS ANTONIO MANTECA-ELIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
494 LEE ST, DES PLAINES, IL 60016-4607
(847) 297-1515
(847) 297-3390
Mailing address
1832 WEEG WAY, PARK RIDGE, IL 60068-1230
(847) 384-0346
(847) 384-0543
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26132
AZ
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03609197802
—
IL
Enumeration date
03/08/2006
Last updated
07/08/2007
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