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Organization
MEADOWS MEDICAL GROUP, LTD
Active
Organization
MEADOWS MEDICAL GROUP, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINA M MANIQUIS M.D. (DOCTOR)
(847) 231-6026
Entity
Organization
Contact information
Practice address
1170 E BELVIDERE RD, SUITE 209, GRAYSLAKE, IL 60030-2034
(847) 231-6026
(847) 231-6029
Mailing address
1170 E BELVIDERE RD, SUITE 209, GRAYSLAKE, IL 60030-2034
(847) 231-6026
(847) 231-6029
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042618432
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932372
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/23/2007
Last updated
04/22/2008
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