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General NPI Number Information
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NPI Number | 1952180309
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Entity Type | Individual
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Provider Name | MADELINE MINAUDO
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Gender | Female
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 3431 N OAKLEY AVE UNIT BSMT
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City | CHICAGO
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State | IL
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Zip | 60618-4884
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Country | US
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Telephone | 815-263-2202
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Fax |
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Provider Business Mailing Address
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Address Line | 1636 N WELLS ST APT 1214
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City | CHICAGO
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State | IL
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Zip | 60614-6013
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Country | US
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Telephone | 574-383-0983
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146.016188
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License Number State | IL
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