| Ronnie Mandal Do, Sc | |
|
2740 W Foster Ave Ste 101 Chicago IL 60625-3547 | |
| (773) 545-9500 | |
| Not Available |
| Full Name | Ronnie Mandal Do, Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2740 W Foster Ave Ste 101, Chicago, Illinois |
| Authorized Official Name and Position | Ronnie Ranjan Mandal (PRESIDENT) |
| Authorized Official Contact | 8477575880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronnie Mandal Do, Sc 6634 N Trumbull Ave Lincolnwood IL 60712-3738 Ph: (847) 757-5880 | Ronnie Mandal Do, Sc 2740 W Foster Ave Ste 101 Chicago IL 60625-3547 Ph: (773) 545-9500 |
| NPI Number | 1790233609 |
|---|---|
| Provider Enumeration Date | 09/20/2016 |
| Last Update Date | 08/17/2021 |
| Medicare PECOS PAC ID | 5890194393 |
|---|---|
| Medicare Enrollment ID | O20210603002403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790233609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 282N00000X | General Acute Care Hospital | 036119779 (Illinois) | Secondary |
| Provider Name | Ronnie Ranjan Mandal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104002872 PECOS PAC ID: 0244303543 Enrollment ID: I20080721000093 |
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