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NPI Code Detail

MEDICARE: MANDANA TOOLE DO

MEDICARE: MANDANA TOOLE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianIL

General Provider Information

NPI Number : 1083668313
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDANA TOOLE DO
Provider Business Mailing Address
First Line : DEPT. 20-DIV001
Second Line : PO BOX 5940
City : CAROL STREAM
State : IL
Zip : 60197-5940
Country : US
Telephone Number : 630-734-0200
Fax Number :
Provider Business Practice Location Address
First Line : 1431 W. CLAREMONT
Second Line :
City : CHICAGO
State : IL
Zip : 60622-1791
Country : US
Telephone Number : 312-770-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 07/08/2007

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Directions to “ MANDANA TOOLE DO” Practice Location

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