Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jesus Mancilla Sr., RSA

Individual provider Specialist · NPI 1205965050

Mr. Jesus Mancilla Sr., RSA is a Specialist in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2007
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Practice location Address checks out

3538 W Fullerton Ave
Chicago, IL 60647-2443
Phone: (773) 772-1212
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X (IL)

Record details

NPI number1205965050
Entity typeIndividual (Type 1)
GenderMale
Credentials RSA
Sole proprietorYes
NPI enumeratedMarch 5, 2007
Last updated in NPPESJuly 8, 2007

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