Individual
DR. JONATHAN ERIC MANNHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1950 W POLK ST, CHICAGO, IL 60612-3723
(312) 864-1810
Mailing address
1950 W POLK ST, CHICAGO, IL 60612-3723
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036.155211
IL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
036.155211
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.155211
DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
05/30/2018
Last updated
07/30/2024
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