Mandala, Cassie L

Mandala, Cassie L is an individual health care provider with primary practice located at 2525 Kaneville Rd , Geneva IL 60134-2578. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mandala, Cassie L can be contacted via phone (630) 584-1400.

Contact Information

Primary practice address
2525 Kaneville Rd Geneva IL 60134-2578
Phone: (630) 584-1400
Fax: (630) 584-1733
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085002999 Illinois

Profile Details

NPI number 1932383445
LBN Legal business name Mandala, Cassie L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2007
Last updated Feb 5th, 2013 - about 12 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 1932383445 NPPES
Other 753210 MEDICARE GROUP

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