Manjarres, Rodrigo

Manjarres, Rodrigo is an individual health care provider with primary practice located at 3012 Grand Ave , Waukegan IL 60085-2321. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Manjarres, Rodrigo can be contacted via phone (847) 546-0080.

Contact Information

Primary practice address
3012 Grand Ave Waukegan IL 60085-2321
Phone: (847) 546-0080
Fax: (847) 546-0083
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 5176 Illinois
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Illinois

Profile Details

NPI number 1376563916
LBN Legal business name Manjarres, Rodrigo
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Jul 16th, 2007 - about 17 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 1376563916 NPPES
Illinois Other 8008517498 BLUECROSS BLUESHIELD

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