| Acute Mantis Care | |
|
7800 N Milwaukee Ave Niles IL 60714-3124 | |
| (312) 809-0777 | |
| (773) 492-8783 |
| Full Name | Acute Mantis Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 7800 N Milwaukee Ave, Niles, Illinois |
| Authorized Official Name and Position | Elena Tiran (PRESIDENT) |
| Authorized Official Contact | 7735411826 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acute Mantis Care 6050 N California Ave Chicago IL 60659-3916 Ph: (312) 809-0777 | Acute Mantis Care 7800 N Milwaukee Ave Niles IL 60714-3124 Ph: (312) 809-0777 |
| NPI Number | 1467053306 |
|---|---|
| Provider Enumeration Date | 11/06/2020 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/17/2023 |
| Medicare PECOS PAC ID | 1850706052 |
|---|---|
| Medicare Enrollment ID | O20210222001414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467053306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | () | Primary |
| Provider Name | Maria a Bordeianu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114549755 PECOS PAC ID: 9830504042 Enrollment ID: I20210222001999 |
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