Healthcare Provider Details

I. General information

NPI: 1184530511
Provider Name (Legal Business Name): MADELYN VONDERFECHT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

4029 MILL ST
KANSAS CITY MO
64111-3008
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 816-285-0022
  • Fax: 816-897-0189
Mailing address:
  • Phone: 630-575-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2026040687
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: