Healthcare Provider Details

I. General information

NPI: 1780591743
Provider Name (Legal Business Name): MADELYN GRACE BAYGOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1804 CENTRE POINT CIR STE 102
NAPERVILLE IL
60563-4849
US

IV. Provider business mailing address

1453 POPLAR CT
LOMBARD IL
60148-4244
US

V. Phone/Fax

Practice location:
  • Phone: 630-955-1940
  • Fax:
Mailing address:
  • Phone: 630-286-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-447032
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: