Mary Beth Madonna
Pediatric Surgery
2300 N Childrens Plz
Chicago
, Illinois 60614-3363
Mary Beth Madonna
Pediatric Surgery
2300 N Childrens Plz
Chicago
, Illinois 60614-3363
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Mary Beth Madonna
- 35422 Eagle Way
- Chicago, IL
- Zip : 60678-1354
- Phone :
Second Address
- Mary Beth Madonna
- 2300 N Childrens Plz
- Chicago, IL
- Zip : 60614-3363
- Phone : (630) 789-2550
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 036-083049 | IL |
National Provider Identifier
| NPI | 1265427108 |
|---|---|
| Provider Name | Mary Beth Madonna |
| First Address | Chicago, IL 60678-1354 |
| Second Address | Chicago, IL 60614-3363 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/09/2005 |
| Last Update Date | 01/04/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036083049 | (05) | IL |
| 1627123 | BCBS PROVIDER ID (01) | IL |
| H27433 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.