Mantelman, Andrew Gene

Mantelman, Andrew Gene is an sole proprietor health care provider with primary practice located at 704 Pintail Ct , Deerfield IL 60015-3645. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Mantelman, Andrew Gene can be contacted via phone (847) 219-9600.

Contact Information

Primary practice address
704 Pintail Ct Deerfield IL 60015-3645
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1366597676
LBN Legal business name Mantelman, Andrew Gene
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 24th, 2007
Last updated Jul 8th, 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 1366597676 NPPES
Illinois Other 04926447 BCBS

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