NPIMap

Organization Active NPI

Eugene Mandrea, M.D., S.C.

  • Dermatology Physician
  • Palos Heights, IL
National Provider Identifier
1184615387
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
EUGENE MANDREA, M.D., S.C.
Practice address
7300 W College Dr
Suite1Nw
Palos Heights, IL 60463-1152
Phone
(708) 671-1374
Fax
(708) 671-1378
NPI assigned
Nov 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eugene Mandrea, M.D.
Title
Physician
Phone
(708) 671-1374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

7300 W College Dr
Suite1Nw
Palos Heights, IL 60463-1152

Mailing address

1730 Park St
Suite 101
Naperville, IL 60563-2688
Phone (630) 718-0200

Other identifiers 1

IdentifierTypeStateIssuer
01604498OtherILBLUE CROSS / BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184615387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 PARK ST",
            "address_2": "SUITE 101",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632688",
            "telephone_number": "630-718-0200",
            "fax_number": "630-718-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 W COLLEGE DR",
            "address_2": "SUITE1NW",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631152",
            "telephone_number": "708-671-1374",
            "fax_number": "708-671-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE MANDREA, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANDREA",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-671-1374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "01604498",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.