Healthcare Provider Details

I. General information

NPI: 1992611586
Provider Name (Legal Business Name): MADELINE ANNE REHNQUIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SILVER CROSS BLVD
NEW LENOX IL
60451-9509
US

IV. Provider business mailing address

21454 W GEORGETOWN DR
PLAINFIELD IL
60544-6109
US

V. Phone/Fax

Practice location:
  • Phone: 815-300-7264
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041528596
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: