Healthcare Provider Details
I. General information
NPI: 1720773658
Provider Name (Legal Business Name): MANISHA SINGH MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/06/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3232 LAKE AVE STE 330
WILMETTE IL
60091-1085
US
IV. Provider business mailing address
29373 NETWORK PL
CHICAGO IL
60673-1293
US
V. Phone/Fax
- Phone: 224-226-9420
- Fax: 847-256-2140
- Phone: 847-390-5900
- Fax: 847-390-4757
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036181888 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: