Aguila-Manalo, Marisa S

Aguila-Manalo, Marisa S is an sole proprietor health care provider with primary practice located at 7447 W Talcott Ave Suite 312, Chicago IL 60631-3714. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Aguila-Manalo, Marisa S can be contacted via phone (773) 467-9925.

Contact Information

Primary practice address
7447 W Talcott Ave Suite 312 Chicago IL 60631-3714
Phone: (773) 467-9925
Fax: (773) 467-9938
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036068818 Illinois

Profile Details

NPI number 1124018189
LBN Legal business name Aguila-Manalo, Marisa S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2005
Last updated Oct 10th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124018189 NPPES
Illinois Other 01632143 BCBS
Illinois MEDICAID 036068818 BCBS

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