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Mr. Jesus Mancilla SR., RSA
Specialist in Chicago, Illinois
NPI 1205965050

Jesus Mancilla SR. is a Specialist based in Lyons, IL. Jesus Mancilla SR. practices in Chicago, IL and has the professional credentials of RSA. The NPI Number for Jesus Mancilla SR. is 1205965050 and holds a License No. (Illinois).

The current practice location address for Jesus Mancilla SR. is 3538 W Fullerton Ave, Chicago, IL and can be reached out via phone at 773-772-1212.

Location: 3538 W Fullerton Ave, Chicago, IL, 60534-1165
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205965050
Provider Name
Jesus Mancilla SR.
Credential
RSA
Provider Entity Type
Individual
Gender
Male
Address
3538 W Fullerton Ave, Chicago, IL, 60534-1165
Phone Number
773-772-1212
Fax Number
Provider Enumeration Date
03/05/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3538 W Fullerton Ave
City
Chicago
State
Illinois
Zip
60647-2443
Phone Number
773-772-1212
Fax Number
person
Provider Business Mailing Address Details
Address
3538 W Fullerton Ave
City
Chicago
State
Illinois
Zip
60647-2443
Phone Number
773-772-1212
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
(Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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