Provider Demographics
NPI:1700232501
Name:SANCHEZ CASALONGUE, MANUEL EDUARDO (MD/PHD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:EDUARDO
Last Name:SANCHEZ CASALONGUE
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 OGDEN AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7205
Mailing Address - Country:US
Mailing Address - Phone:630-585-0200
Mailing Address - Fax:630-585-7396
Practice Address - Street 1:2040 OGDEN AVE STE 115
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7205
Practice Address - Country:US
Practice Address - Phone:630-585-0200
Practice Address - Fax:630-585-7396
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-02428208000000X
390200000X
IL036159869208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program