Provider Demographics
NPI:1629321112
Name:MANSFIELD, JAMES BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRUCE
Last Name:MANSFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5 LOCH LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9532
Mailing Address - Country:US
Mailing Address - Phone:847-304-0369
Mailing Address - Fax:847-304-6946
Practice Address - Street 1:5 LOCH LN
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9532
Practice Address - Country:US
Practice Address - Phone:847-304-0369
Practice Address - Fax:847-304-6946
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-21
Last Update Date:2012-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-010529207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery