Organization
THE MEDADDRESS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINA S MANIQUIS M.D. (PRESIDENT)
(847) 522-7505
Entity
Organization
Contact information
Practice address
303 E PARK AVE, SUITE 103, LIBERTYVILLE, IL 60048-2898
(847) 522-7505
Mailing address
303 E PARK AVE, STE 103, LIBERTYVILLE, IL 60048-2872
(847) 522-7505
(847) 522-7504
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042619466
—
IL
Enumeration date
02/18/2009
Last updated
05/08/2026
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