NICCOLO EMANUELE MENCACCI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

Title

First Name

NICCOLO

Middle

EMANUELE

Last Name

MENCACCI

Business Name

NICCOLO EMANUELE MENCACCI MD

Original Issue Date

07/27/2021

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023