MEDICARE: RADMILA M. MANEV M.D.

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
1	2084P0800X	Psychiatry Physician	036094078	IL

General Provider Information

NPI Number	:	1447363601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RADMILA M. MANEV M.D.

Provider Business Mailing Address
First Line	:	180 N MICHIGAN AVE
Second Line	:	SUITE 905
City	:	CHICAGO
State	:	IL
Zip	:	60601-7401
Country	:	US
Telephone Number	:	312-834-3005
Fax Number	:	312-453-0224

Provider Business Practice Location Address
First Line	:	180 N MICHIGAN AVE
Second Line	:	SUITE 905
City	:	CHICAGO
State	:	IL
Zip	:	60601-7401
Country	:	US
Telephone Number	:	312-834-3005
Fax Number	:	312-453-0224

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	02/04/2011

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