MEDICARE: MS. MELANIE LYNN MADIGAN LCSW

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	1041C0700X	Clinical Social Worker		IL

General Provider Information

NPI Number	:	1326198557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELANIE LYNN MADIGAN LCSW

Provider Business Mailing Address
First Line	:	2241 W WALTON ST
Second Line	:	#3
City	:	CHICAGO
State	:	IL
Zip	:	60622-4816
Country	:	US
Telephone Number	:	917-561-3606
Fax Number	:	847-446-1015

Provider Business Practice Location Address
First Line	:	2000 N RACINE AVE
Second Line	:	SUITE 2300
City	:	CHICAGO
State	:	IL
Zip	:	60614-4045
Country	:	US
Telephone Number	:	312-952-3599
Fax Number	:	847-446-1015

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/08/2007

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