| Doctor Name: | JOSE I MANGLANO |
| NPI Number: | 1295799567 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 036042243 |
| Business Practice Address: | 2320 High St Blue Island, IL - 604062426 |
| Business Phone Number: | 7083885500 |
| Business Fax Number: | 7083885672 |
| Mailing Address: | 2320 High St, BLUE ISLAND |
| State: | IL |
| Postal Code: | 604062426 |
| Phone Number: | 7083885500 |
| Fax Number: | 7083885672 |
| NPI Enumeration Date: | 04/13/2006 |
| NPI Last Update Date: | 01/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 036042243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |