Healthcare Provider Details

I. General information

NPI: 1992498232
Provider Name (Legal Business Name): MANALI CHINGRE DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 IL-21 STE 140
GURNEE IL
60031
US

IV. Provider business mailing address

475 MOCKINGBIRD CT
LINDENHURST IL
60046-4933
US

V. Phone/Fax

Practice location:
  • Phone: 847-999-4625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number5951001517
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: