MEDICARE: LISSET MADERA-GONZALEZ

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1144163320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISSET MADERA-GONZALEZ

Provider Business Mailing Address
First Line	:	6231 S ALBANY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-2615
Country	:	US
Telephone Number	:	773-396-3577
Fax Number	:

Provider Business Practice Location Address
First Line	:	4815 S KARLOV AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-4123
Country	:	US
Telephone Number	:	773-535-4875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

Similar Medicare Providers

1336504471 — LA CLINICA SC
Practice Location Address:

4123 W FULLERTON AVE
CHICAGO, IL
60639-2105

Practice Phone: 773-278-9525
Practice Fax: 708-337-9135

1356894182 — CYNTHIA IVETTE SANCHEZ-FRANCO PTA
Practice Location Address:

3508 W MARQUETTE RD
CHICAGO, IL
60629-4123

Practice Phone: 773-793-1507
Practice Fax:

1649722232 — MINDY DENISE STILLMAN LCSW, CCM
Practice Location Address:

1636 W OLIVE AVE , 1N
CHICAGO, IL
60660-4123

Practice Phone: 847-778-0419
Practice Fax:

1952952798 — GWENDOLYN UPSHAW
Practice Location Address:

4123 GRACE ST
EAST CHICAGO, IN
46312-2924

Practice Phone: 937-974-6277
Practice Fax:

1093483380 — DR. MICHAEL COREY WOODS DC
Practice Location Address:

4123 W FULLERTON AVE
CHICAGO, IL
60639-2105

Practice Phone: 773-278-9525
Practice Fax:

1104665496 — BENJAMIN DURCHSLAG LCSW PC
Practice Location Address:

837 S RACINE AVE
CHICAGO, IL
60607-4123

Practice Phone: 312-860-9552
Practice Fax:

Directions to “ LISSET MADERA-GONZALEZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.