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General NPI Number Information
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NPI Number | 1265479158
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Entity Type | Organization
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Legal Business Name | MANUEL CESAR IGLESIAS, M.D., S.C.
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 1111 SUPERIOR ST SUITE 409
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City | MELROSE PARK
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State | IL
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Zip | 60160-4138
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Country | US
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Telephone | 708-681-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 8135 N MILWAUKEE AVE
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City | NILES
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State | IL
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Zip | 60714-2828
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Country | US
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Telephone | 847-967-1149
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Fax | 847-967-8594
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANUEL C. IGLESIAS
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Credential | M.D.
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Telephone | 847-967-1149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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