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General NPI Number Information
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NPI Number | 1265996631
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Entity Type | Individual
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Provider Name | MADELINE S. LUBENOW APN-CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/30/2019
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 875 S ROUTE 31
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-8190
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Country | US
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Telephone | 779-220-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 29624 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1296
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Country | US
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Telephone | 608-756-6278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209.018751
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License Number State | IL
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