Active NPI
Juilio A Mancera, M.D.
- Preventive Medicine/Occupational Environmental Medicine Physician
- Morton Grove, IL
National Provider Identifier
1073630315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- 036-059326
- Practice address
- 8125 River Dr
Morton Grove, IL 60053-2642 - Phone
- (615) 778-4066
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 036-059326 | IL | Primary |
Addresses
Primary practice location
8125 River Dr
Morton Grove, IL 60053-2642
Mailing address
5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-4648
Phone (972) 364-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266451200000",
"number": "1073630315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 SPECTRUM DR",
"address_2": "SUITE 1200W",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014648",
"telephone_number": "972-364-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8125 RIVER DR",
"city": "MORTON GROVE",
"state": "IL",
"postal_code": "600532642",
"telephone_number": "615-778-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCERA",
"first_name": "JUILIO",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2010-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "IL",
"license": "036-059326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morton Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.