Individual
JAKE ANTHONY MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1290
(708) 923-4000
(708) 923-5859
Mailing address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1290
(708) 923-4000
(708) 923-5859
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036159971
IL
208M00000X
Hospitalist Physician
Primary
036159971
IL
390200000X
Student in an Organized Health Care Education/Training Program
125074314
IL
Other
Enumeration date
05/29/2019
Last updated
06/05/2024
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