Individual
PAIGE C MANIAKOURAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
4440 W 95TH ST FL 8, OAK LAWN, IL 60453-2600
(708) 684-4200
(708) 520-1885
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-0018
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006021
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085006021
IL LICENSE NO
IL
Enumeration date
10/04/2016
Last updated
09/22/2025
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