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General NPI Number Information
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NPI Number | 1669655569
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Entity Type | Individual
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Provider Name | ARTHUR MICHAEL MANDELIN II MD/PHD
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Gender | Male
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 675 N SAINT CLAIR ST SUITE 14-100
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City | CHICAGO
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State | IL
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Zip | 60611-5975
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Country | US
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Telephone | 312-695-8628
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Fax | 312-695-0114
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Provider Business Mailing Address
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Address Line | 675 N SAINT CLAIR ST SUITE 14-100
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City | CHICAGO
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State | IL
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Zip | 60611-5975
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Country | US
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Telephone | 312-695-8628
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Fax | 312-695-0114
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-118442
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 036-118442
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License Number State | IL
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