Healthcare Provider Details

I. General information

NPI: 1568351484
Provider Name (Legal Business Name): MADISYN MARIE HENNING JONES OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 W DIVISION ST STE 135
CHICAGO IL
60622-2967
US

IV. Provider business mailing address

4620 JOHNSON AVE
WESTERN SPRINGS IL
60558-1539
US

V. Phone/Fax

Practice location:
  • Phone: 773-804-8310
  • Fax:
Mailing address:
  • Phone: 708-476-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046.012127
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: