The Medaddress, S.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

THE MEDADDRESS, S.C.

Practice address

303 E Park Ave
Suite 103
Libertyville, IL 60048-2898

Phone

(847) 522-7505

NPI assigned

Feb 18, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nina S Maniquis, M.D.NPI 1649212010

Title

President

Phone

(847) 522-7505

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nina Socorro E. Maniquis, M.D.

  • Family Medicine Physician
  • Libertyville, IL
  • NPI 1649212010
  Medicare reassignment Care Compare group NPD Authorized official
• Vina Maria Estipona Maniquis, MD

  • Family Medicine Physician
  • Libertyville, IL
  • NPI 1851497119
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1205075942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E PARK AVE",
            "address_2": "STE 103",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482872",
            "telephone_number": "847-522-7505",
            "fax_number": "847-522-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E PARK AVE",
            "address_2": "SUITE 103",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482898",
            "telephone_number": "847-522-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDADDRESS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "MANIQUIS",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-522-7505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042619466",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Family Stress Clinic
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• The Libertyville Surgeons, S C
• The McKnight Group LLC (Living Pono Counseling)
• The Pilates PT LLC
• Rebecca Anne Thibaudeau, DDS
• Thomas H Burnstine, M.D.,S.C.
• Thomas N Porter MD SC
• David Thomas, M.D.

• Primary Care Clinic/Center in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.