DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SPENCER MADDEN

MEDICARE: SPENCER MADDEN
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
1103K00000XBehavior AnalystIL

General Provider Information

NPI Number : 1538099098
Entity Type Code : Individual
Provider Name (Legal Business Name) : SPENCER MADDEN
Provider Business Mailing Address
First Line : 1385 NEWPORT ST
Second Line :
City : MUNDELEIN
State : IL
Zip : 60060-4626
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 105 N GREENLEAF ST
Second Line :
City : GURNEE
State : IL
Zip : 60031-3326
Country : US
Telephone Number : 847-390-2271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2026
Last Update Date : 05/19/2026

Similar Medicare Providers

1508795287 — ALEXANDRA LOZA RBT
Practice Location Address:
105 N GREENLEAF ST STE B
GURNEE, IL
60031-3326
Practice Phone: 630-465-3963
Practice Fax:
1881523587 — KAITLYN DURAN BS
Practice Location Address:
105 N GREENLEAF ST STE B
GURNEE, IL
60031-3326
Practice Phone: 630-465-3963
Practice Fax:
1124957790 — ELDANA SATYMKULOVA
Practice Location Address:
105 N GREENLEAF ST STE B
GURNEE, IL
60031-3326
Practice Phone: 847-390-2271
Practice Fax:
1366371957 — CORETTA GODBOLD
Practice Location Address:
105 N GREENLEAF ST STE B
GURNEE, IL
60031-3326
Practice Phone: 847-390-2271
Practice Fax:
1184554610 — ELLIE ROSE SCHULZ
Practice Location Address:
105 N GREENLEAF ST STE B
GURNEE, IL
60031-3326
Practice Phone: 847-604-0955
Practice Fax:
1518897057 — JULIANNE ROLDAN
Practice Location Address:
105 N GREENLEAF ST
GURNEE, IL
60031-3326
Practice Phone: 847-390-2271
Practice Fax:

Directions to “ SPENCER MADDEN ” 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.