NATHANIEL MANCILLAS

CHICAGO, IL
NPI1023550720
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: IL  070022749)
Enumeration Date2016-11-11
Last Update Date2016-12-09
Business Address
-- NATHANIEL MANCILLAS DPT
1747 E 95TH ST
CHICAGO, IL 60617-4708
Phone number: 773-375-8711
Mailing Address
-- NATHANIEL MANCILLAS DPT
625 ENTERPRISE DR
OAK BROOK, IL 60523-8813
Phone number: 630-575-6250