Healthcare Provider Details

I. General information

NPI: 1952461972
Provider Name (Legal Business Name): MADDALENA DENEUFBOURG CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 HIGHLAND AVE STE 5B
DOWNERS GROVE IL
60515-1551
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-0001
US

V. Phone/Fax

Practice location:
  • Phone: 630-963-9963
  • Fax: 630-963-9667
Mailing address:
  • Phone: 847-390-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209006312
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: