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General NPI Number Information
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NPI Number | 1093363236
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Entity Type | Organization
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Legal Business Name | STEPHEN A MADRY MD
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Dates
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Enumeration Date | 08/30/2019
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 27750 W IL ROUTE 22 STE 230
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City | BARRINGTON
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State | IL
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Zip | 60010-1924
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Country | US
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Telephone | 847-382-9902
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Fax |
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Provider Business Mailing Address
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Address Line | 27750 W IL ROUTE 22 STE 230
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City | BARRINGTON
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State | IL
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Zip | 60010-1924
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Country | US
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Telephone | 847-382-9902
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MALGORZATA GODLEWSKA
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Credential |
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Telephone | 847-382-9902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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