Doctor Name: | JUILIO A MANCERA |
NPI Number: | 1073630315 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036-059326 |
Business Practice Address: | 8125 River Dr Morton Grove, IL - 600532642 |
Business Phone Number: | 6157784066 |
Business Fax Number: | |
Mailing Address: | 5080 Spectrum Dr, Suite 1200w ADDISON |
State: | TX |
Postal Code: | 750014648 |
Phone Number: | 9723648000 |
Fax Number: | |
NPI Enumeration Date: | 03/23/2007 |
NPI Last Update Date: | 02/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2083P0500X |
License Number: | 036-059326 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Preventive Medicine |
Taxonomy Specialization: | Preventive Medicine/Occupational Environmental Medicine |
Taxonomy Definition: | A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |