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General NPI Number Information
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NPI Number | 1164604245
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Entity Type | Organization
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Legal Business Name | ANETTE K. MNABHI D.O. P.C.
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 115 N MAIN ST
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City | MONTGOMERY
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State | IL
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Zip | 60538-1298
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Country | US
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Telephone | 630-801-8773
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Fax | 630-264-6734
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Provider Business Mailing Address
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Address Line | 115 N MAIN ST
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City | MONTGOMERY
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State | IL
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Zip | 60538-1298
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Country | US
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Telephone | 630-801-8773
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Fax | 630-264-6734
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANETTE K MNABHI
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Credential | D.O.
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Telephone | 630-801-8773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State | IL
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