NPI 1720316706

Jacqueline M Mondji Mamba

Practitioner Driver Bolingbrook, IL

Practice location

Address: 1475 Basswood Dr, Bolingbrook, IL 60490-5419
Phone: (630) 759-4232
Fax: (630) 759-0327

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

Other Driver providers in Illinois →

Registry record

NPI: 1720316706
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Dec 2009
Record last updated: 2 Dec 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.