MEDICARE: MADDALENA DENEUFBOURG CNP

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	363L00000X	Nurse Practitioner	209006312	IL

General Provider Information

NPI Number	:	1952461972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADDALENA DENEUFBOURG CNP

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-0001
Country	:	US
Telephone Number	:	847-390-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3825 HIGHLAND AVE STE 5B
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1551
Country	:	US
Telephone Number	:	630-963-9963
Fax Number	:	630-963-9667

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	08/08/2025

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