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NPI Code Detail

MEDICARE: EUGENE MANDREA, M.D., S.C.

MEDICARE: EUGENE MANDREA, M.D., S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101604498OTHERILBLUE CROSS / BLUE SHIELD

General Provider Information

NPI Number : 1184615387
Entity Type Code : Organization
Provider Name (Legal Business Name) : EUGENE MANDREA, M.D., S.C.
Provider Business Mailing Address
First Line : 1730 PARK ST
Second Line : SUITE 101
City : NAPERVILLE
State : IL
Zip : 60563-2688
Country : US
Telephone Number : 630-718-0200
Fax Number : 630-718-0900
Provider Business Practice Location Address
First Line : 7300 W COLLEGE DR
Second Line : SUITE1NW
City : PALOS HEIGHTS
State : IL
Zip : 60463-1152
Country : US
Telephone Number : 708-671-1374
Fax Number : 708-671-1378
Authorized Official
Title or Position : PHYSICIAN
Name : DR. EUGENE MANDREA
Credential : M.D.
Telephone Number : 708-671-1374
Provider Enumeration Date : 11/04/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

1891786067 — DR. EUGENE MANDREA M.D.
Practice Location Address:
7300 W COLLEGE DR , SUITE 1NW
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-671-1374
Practice Fax: 708-671-1378
1063497345 — PALOS PSYCHIATRIC & RECOVERY INST LTD
Practice Location Address:
7300 W COLLEGE DR , 101
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Practice Phone: 708-448-8470
Practice Fax: 708-448-9651
1609851740 — NORTH SHORE WELLNESS CENTER LTD
Practice Location Address:
7300 W COLLEGE DR , SUITE 101
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-448-8470
Practice Fax: 708-448-9651
1639134224 — MS. DANIELLE P GLICKLEY LSW
Practice Location Address:
7300 W COLLEGE DR , 101
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-448-8470
Practice Fax: 708-448-9651
1770509648 — KEITH ALAN LOPATKA M.D.
Practice Location Address:
7300 W COLLEGE DR , STE 1NW
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-671-1374
Practice Fax: 708-671-1378
1831110279 — MRS. BERNICE IK-JANG MI JOHNSON PHYISICAN ASSISTANT
Practice Location Address:
7300 W COLLEGE DR , 1NW
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-671-1374
Practice Fax: 708-671-1378

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