Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miriam Manrique

Individual provider Nurse Practitioner · NPI 1104686203

Miriam Manrique is a Nurse Practitioner in LA Grange Park, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2024

Practice location Address checks out

321 N La Grange Rd
LA Grange Park, IL 60526-5622
Phone: (708) 745-5277
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209.029153 (IL)

Record details

NPI number1104686203
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 19, 2024
Last updated in NPPESAugust 6, 2024
Certification dateAugust 6, 2024
Mailing address5220 East Ave, Countryside, IL 60525-3133