Provider Demographics
NPI:1285960880
Name:MANI-SANA,S.C.
Entity type:Organization
Organization Name:MANI-SANA,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUSALINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MUNTEAN-MINCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-405-9822
Mailing Address - Street 1:1124 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2923
Mailing Address - Country:US
Mailing Address - Phone:847-405-9822
Mailing Address - Fax:
Practice Address - Street 1:6142 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-2687
Practice Address - Country:US
Practice Address - Phone:848-828-3594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center