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1023550720
NATHANIEL MANCILLAS
CHICAGO, IL
NPI
1023550720
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070022749)
Enumeration Date
2016-11-11
Last Update Date
2016-12-09
Business Address
-- NATHANIEL MANCILLAS DPT
1747 E 95TH ST
CHICAGO, IL 60617-4708
Phone number: 773-375-8711
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Mailing Address
-- NATHANIEL MANCILLAS DPT
625 ENTERPRISE DR
OAK BROOK, IL 60523-8813
Phone number: 630-575-6250
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