Healthcare Provider Details

I. General information

NPI: 1043885262
Provider Name (Legal Business Name): MADELEINE J HOLICKI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADELEINE J MCBAIN OD

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 E CHICAGO RD STE B
COLDWATER MI
49036-8449
US

IV. Provider business mailing address

142 E CHICAGO RD STE B
COLDWATER MI
49036-8449
US

V. Phone/Fax

Practice location:
  • Phone: 517-279-7927
  • Fax: 517-278-3393
Mailing address:
  • Phone: 517-279-7927
  • Fax: 517-278-3393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18004544A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901005763
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT006975
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: