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General NPI Number Information
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NPI Number | 1437277928
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Entity Type | Organization
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Legal Business Name | EP MANN MD LTD
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 5850 WEST LLLTH STREET
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City | CHICAGO RIDGE
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State | IL
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Zip | 60415-2220
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Country | US
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Telephone | 708-425-2466
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Fax | 708-425-4796
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Provider Business Mailing Address
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Address Line | PO BOX 379
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City | ORLAND PARK
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State | IL
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Zip | 60462-0379
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Country | US
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Telephone | 708-460-9836
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Fax | 708-460-1117
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWARD PHILIP MANN
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Credential | MD
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Telephone | 708-425-2466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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