Individual
CASSIE L MANDALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2525 KANEVILLE RD, GENEVA, IL 60134-2578
(630) 584-1400
(630) 584-1733
Mailing address
2525 KANEVILLE RD, GENEVA, IL 60134-2578
(630) 584-1400
(630) 584-1733
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002999
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
753210
MEDICARE GROUP
—
Enumeration date
12/19/2007
Last updated
02/05/2013
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