NPI 1184809048

Rodolfo Pineda Manansala, INDEPENDENTDUTYHM

Practitioner Independent Duty Corpsman Great Lakes, IL

Practice location

Address: 601 D St Bldg 130-H, Great Lakes, IL 60088-2822
Phone: (847) 688-3412
Mailing address: 950 Elfering Ln, Antioch, IL 60002-6404

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X Licence 1710I1002X (CA)

Other Military Health Care Provider providers in Illinois →

Registry record

NPI: 1184809048
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Jan 2008
Record last updated: 27 Aug 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.