Provider Demographics
NPI:1598213316
Name:ANDREA MANN, DO, LLC
Entity Type:Organization
Organization Name:ANDREA MANN, DO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:PARISA
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:312-566-8674
Mailing Address - Street 1:30 N MICHIGAN AVE STE 901
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3767
Mailing Address - Country:US
Mailing Address - Phone:312-566-8674
Mailing Address - Fax:312-275-7553
Practice Address - Street 1:30 N MICHIGAN AVE STE 901
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3767
Practice Address - Country:US
Practice Address - Phone:312-566-8674
Practice Address - Fax:312-275-7553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1311762084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty