| Cesar G. Maniquis, M.d., Ltd. | |
|
303 E Park Ave Suite 103 Libertyville IL 60048-2898 | |
| (847) 362-5650 | |
| (847) 362-5843 |
| Full Name | Cesar G. Maniquis, M.d., Ltd. |
|---|---|
| Speciality | Clinic/center |
| Location | 303 E Park Ave, Libertyville, Illinois |
| Authorized Official Name and Position | Cesar G Maniquis (PRESIDENT/OWNER) |
| Authorized Official Contact | 8473625650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cesar G. Maniquis, M.d., Ltd. 303 E Park Ave Suite 103 Libertyville IL 60048-2898 Ph: (847) 362-5650 | Cesar G. Maniquis, M.d., Ltd. 303 E Park Ave Suite 103 Libertyville IL 60048-2898 Ph: (847) 362-5650 |
| NPI Number | 1154648855 |
|---|---|
| Provider Enumeration Date | 04/21/2010 |
| Last Update Date | 09/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154648855 | NPI | - | NPPES |
| 036048767 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3648767 (Illinois) | Primary |
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