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NPI Code Detail

MEDICARE: SARA L MADSEN DO

MEDICARE: SARA L MADSEN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician036-143430IL
22085R0202XDiagnostic Radiology Physician72693WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104243252
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA L MADSEN DO
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 9200 W OKLAHOMA AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-4317
Country : US
Telephone Number : 414-649-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2014
Last Update Date : 02/03/2025

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