Healthcare Provider Details

I. General information

NPI: 1609738293
Provider Name (Legal Business Name): MADELYN MAYS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

992 1/2 GREEN BAY RD
WINNETKA IL
60093-1722
US

IV. Provider business mailing address

8017 KOLMAR AVE
SKOKIE IL
60076-3114
US

V. Phone/Fax

Practice location:
  • Phone: 847-446-8060
  • Fax:
Mailing address:
  • Phone: 847-848-6901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number150.110696
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: