Basic Information
| Provider Information | |||||||||
| NPI: | 1518607118 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MANDLIK | ||||||||
| FirstName: | AFRIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7563 CAMBRIDGE RD | ||||||||
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| City: | DARIEN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605614315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176570296 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7632 PLAZA CT | ||||||||
| Address2: | |||||||||
| City: | WILLOWBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605275607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307893338 | ||||||||
| FaxNumber: | 6307893394 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2022 | ||||||||
| LastUpdateDate: | 03/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 070025292 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.