Search › Illinois › 367A00000X
Lacey Manimala
NPI 1023840725 · on the registry since 2024
Practice
- Address
- 1026 Gunderson Ave
Oak Park, IL 60304 - Phone
- (312) 509-1616
Registry record
- Primary taxonomy
- 367A00000X
367A00000X
- Also registered as
- 163WX0002X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-09-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois