Healthcare Provider Details

I. General information

NPI: 1528107950
Provider Name (Legal Business Name): LUANNE MANIACEK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 LARKIN AVE. SUITE 202
ELGIN IL
60123-0000
US

IV. Provider business mailing address

230 LITTLE PENINSULA RD
ELGIN IL
60123-1529
US

V. Phone/Fax

Practice location:
  • Phone: 847-697-2400
  • Fax:
Mailing address:
  • Phone: 847-528-2086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6386
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149001067
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: