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General NPI Number Information
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NPI Number | 1063618122
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Entity Type | Individual
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Provider Name | JUNAID N MANSURI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 1919 S HIGHLAND AVE
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City | LOMBARD
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State | IL
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Zip | 60148-6153
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Country | US
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Telephone | 630-613-9590
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 CLEVELAND ST
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City | SKOKIE
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State | IL
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Zip | 60076-2734
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Country | US
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Telephone | 312-961-0709
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036.124691
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License Number State | IL
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