Provider Demographics
NPI:1386688265
Name:MANN, JOEL U (MD)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:U
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6420 W 127TH ST
Mailing Address - Street 2:STE 108
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463
Mailing Address - Country:US
Mailing Address - Phone:708-371-7838
Mailing Address - Fax:708-371-7839
Practice Address - Street 1:6420 W 127TH ST
Practice Address - Street 2:STE 108
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463
Practice Address - Country:US
Practice Address - Phone:708-371-7838
Practice Address - Fax:708-371-7839
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-09-13
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Provider Licenses
StateLicense IDTaxonomies
IL036043316207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL182910098OtherRR MED
IL21624918OtherBCBS
IL036043316Medicaid
IL478140Medicare PIN
IL036043316Medicaid