Provider Demographics
NPI:1053586438
Name:ARTURO S. MANAS, LTD
Entity type:Organization
Organization Name:ARTURO S. MANAS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:S
Authorized Official - Last Name:MANAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-965-7117
Mailing Address - Street 1:1415 E STATE ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61104-2333
Mailing Address - Country:US
Mailing Address - Phone:815-965-7117
Mailing Address - Fax:
Practice Address - Street 1:1415 E STATE ST
Practice Address - Street 2:SUITE 800
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104-2333
Practice Address - Country:US
Practice Address - Phone:815-965-7117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036061421207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036061421Medicaid
IL203707Medicare PIN
IL036061421Medicaid