Procula Mandin

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

701854 Issued in CA

Practice address

1506 Hillcrest CT
Lombard, IL 60148-4423

Phone

(630) 261-1558

NPI assigned

Jul 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1205210846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 HILLCREST CT",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484423",
            "telephone_number": "630-261-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 HILLCREST CT",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484423",
            "telephone_number": "630-261-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIN",
        "first_name": "PROCULA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "701854",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.270882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renzi Malabanan, RN
• Minirose J Maliekal, MSW
• Kiswa Malik
• Gregory Dean Malo, PSY.D.
• Jocelyn Maltos
• Sebastian Mangune
• Junaid N Mansuri, M.D.
• Joseph Marcuccilli, DO
• Holly Jean Mareski, LCSW, CADC
• West Marinier

• Registered Nurse in Lombard, IL
• Providers in Lombard, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.