Provider Demographics
NPI:1861401044
Name:MANASIA, RAYMOND SALVATORE (DC)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:SALVATORE
Last Name:MANASIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:211 N CLINTON ST
Mailing Address - Street 2:SUITE 2S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1282
Mailing Address - Country:US
Mailing Address - Phone:312-262-7969
Mailing Address - Fax:708-221-7108
Practice Address - Street 1:211 N CLINTON ST
Practice Address - Street 2:SUITE 2S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-1282
Practice Address - Country:US
Practice Address - Phone:312-262-7969
Practice Address - Fax:708-221-7108
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL038007565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor