Individual
JESSE-JAY MANANSALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
39193 N STOCKTON LN, BEACH PARK, IL 60083-3010
(847) 505-4215
Mailing address
39193 N STOCKTON LN, BEACH PARK, IL 60083-3010
(847) 505-4215
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
041516941
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.034904
IL
Other
Enumeration date
02/02/2026
Last updated
02/27/2026
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