The Medaddress, S.c.
NPI #1205075942 in Libertyville, Illinois
Provider Information
- NPI Number
- 1205075942
- Entity Type
- Organization
- Organization Name
- The Medaddress, S.c.
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Feb 18, 2009
- Last Updated
- Nov 2, 2011
Practice Location
- Address
- 303 E PARK AVE
- Address 2
- SUITE 103
- City
- Libertyville
- State
- Illinois
- ZIP Code
- 60048-2872
- Phone
- (847) 522-7505
Authorized Official
- Name
- DR. NINA S MANIQUIS, M.D.
- Title
- PRESIDENT
- Phone
- (847) 522-7505
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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