Dr. Thaddeus Manczko
Emergency Medical Services
350 N Wall St
Kankakee
, Illinois 60901-2901
Dr. Thaddeus Manczko
Emergency Medical Services
350 N Wall St
Kankakee
, Illinois 60901-2901
(734) 995-3764
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About
Features
Specialties
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- Dr. Thaddeus Manczko
- 2000 Green Rd Suite 300
- Ann Arbor, MI
- Zip : 48105-1598
- Phone : (734) 995-3764
Second Address
- Dr. Thaddeus Manczko
- 350 N Wall St
- Kankakee, IL
- Zip : 60901-2901
- Phone : (815) 933-1671
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PE0004X | Emergency Medical Services | 036-100560 | IL |
National Provider Identifier
| NPI | 1073553004 |
|---|---|
| Provider Name | Dr. Thaddeus Manczko |
| First Address | Ann Arbor, MI 48105-1598 |
| Second Address | Kankakee, IL 60901-2901 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/06/2006 |
| Last Update Date | 03/06/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036100560-7 | (05) | IL |
| H03041 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.