IndividualActive
Lukas Manieri, ATC, OTC
NPI 1164939179 · Athletic Trainer · Bloomington, IL
Provider details
- NPI number
- 1164939179
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- ATC, OTC
- Sex
- Male
- Sole proprietor
- No
- License
- 16-06-30 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Technologists, Technicians & Other Technical Service Providers
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1111 Trinity Ln Ste 111
Bloomington, IL 61704-8112
Phone: (309) 663-6461
Fax: (309) 663-5711
Street-level locationGet directions
Mailing address
1226 Airport Rd
Bloomington, IL 61704-2522
Registry dates
- Enumerated
- 2017-12-29
- Last updated
- 2017-12-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.