Search › Illinois › 207Q00000X
Avinash Mantha, MD
NPI 1275952731 · on the registry since 2014
Practice
- Address
- 3046 127th St
Blue Island, IL 60406 - Phone
- (708) 377-7920
- Fax
- (708) 930-0414
- Clinicians at this address
- 12
Additional practice sites
- 40 Arch St, Johnson City, NY
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 390200000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-10-30
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