| Dennis T Manshio Md Phd Sc | |
|
2907 S Wabash Ave Ste 100a Chicago IL 60616-3271 | |
| (773) 477-3699 | |
| (312) 877-5049 |
| Full Name | Dennis T Manshio Md Phd Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 2907 S Wabash Ave Ste 100a, Chicago, Illinois |
| Authorized Official Name and Position | Dennis Manshio (PRESIDENT) |
| Authorized Official Contact | 7734773699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis T Manshio Md Phd Sc 2907 S Wabash Ave Ste 100a Chicago IL 60616-3271 Ph: (773) 477-3699 | Dennis T Manshio Md Phd Sc 2907 S Wabash Ave Ste 100a Chicago IL 60616-3271 Ph: (773) 477-3699 |
| NPI Number | 1710289111 |
|---|---|
| Provider Enumeration Date | 11/17/2010 |
| Last Update Date | 10/30/2024 |
| Medicare PECOS PAC ID | 2062609944 |
|---|---|
| Medicare Enrollment ID | O20101203000752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710289111 | NPI | - | NPPES |
| 042617097 | Other | IL | STATE OF ILLINOIS REGISTERED MEDICAL CORPORATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036065850 (Illinois) | Primary |
| Provider Name | Dennis T Manshio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811026297 PECOS PAC ID: 5799972188 Enrollment ID: I20101210000798 |
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