Manteca-Elias, Jesus Antonio

Manteca-Elias, Jesus Antonio is an sole proprietor health care provider with primary practice located at 494 Lee St , Des Plaines IL 60016-4607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Manteca-Elias, Jesus Antonio can be contacted via phone (847) 297-1515.

Contact Information

Primary practice address
494 Lee St Des Plaines IL 60016-4607
Phone: (847) 297-1515
Fax: (847) 297-3390
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 26132 Arizona
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Illinois

Profile Details

NPI number 1821066879
LBN Legal business name Manteca-Elias, Jesus Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 8th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821066879 NPPES
Illinois MEDICAID 03609197802

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