MARY BETH MADONNA (NPI# 1265427108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265427108 |
| Entity Type | Individual |
| Full Name | MARY BETH MADONNA |
| Credential | MD |
| Practice Address |
2300 N Childrens Plz Chicago IL 60614-3363 |
| Mailing Address |
35422 Eagle Way Chicago IL 60678-1354 |
| Practice Telephone | 6307892550 |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS PROVIDER ID | 1627123 | 01 |
| Street Address |
2300 N CHILDRENS PLZ |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-3363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700880077 | Mari G Leahy | Pharmacist | 2300 N Childrens Plz, Chicago, IL 60614-3363 | 2005-06-02 |
| 1265707616 | Melanie Rae Berube | Social Worker | 2300 N Childrens Plz, Box 10, Chicago, IL 60614-3363 | 2012-03-19 |
| 1326310673 | Dana Marie Koehn | Specialist/Technologist | 2300 N Childrens Plz, Chicago, IL 60614-3363 | 2012-02-02 |
| 1255603908 | Peter Andrew Wagreich | Speech-Language Pathologist | 2300 N Childrens Plz, Box 142, Chicago, IL 60614-3363 | 2012-01-27 |
| 1467722090 | Laura Catherine Doyle | Nurse Practitioner | 2300 N Childrens Plz, #37, Chicago, IL 60614-3363 | 2012-01-12 |
| 1174890362 | Julie Farrell | Nurse Practitioner | 2300 N Childrens Plz, Emergency Department, Chicago, IL 60614-3363 | 2011-11-16 |
| 1508147935 | Heather A. Bryant | Pharmacist | 2300 N Childrens Plz, Suite J119, Walgreens, Chicago, IL 60614-3363 | 2011-08-30 |
| 1811278278 | Roopal Marlow | Pharmacist | 2300 N Childrens Plz, Suite J119, Chicago, IL 60614-3363 | 2011-08-30 |
| 1548548357 | Jenelle Helene Ezcurra | Audiologist | 2300 N Childrens Plz, Chicago, IL 60614-3363 | 2011-07-27 |
| 1700175809 | Rebecca Jeanne Vana | Student in an Organized Health Care Education/Training Program | 2300 N Childrens Plz, Chicago, IL 60614-3363 | 2011-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417141904 | Erik Ryan Barthel | Surgery | 5841 S Maryland Ave # Mc4062, University of Chicago Medicine, Chicago, IL 60637-1447 | 2007-08-28 |
| 1467666081 | Connie Jean Rossini | Surgery | 1725 W Harrison St Ste 708, Chicago, IL 60612-3841 | 2007-05-10 |
| 1356394217 | Childrens Surgical Foundation Inc | Surgery | 225 E Chicago Ave # 114, Chicago, IL 60611-2991 | 2006-05-19 |
| 1356822050 | Lurie Childrens Surgical Foundation Inc | Surgery | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2018-08-22 |
| 1649774803 | Rachael Sundland | Surgery | 5841 S Maryland Ave # Mc4062, Chicago, IL 60637-1443 | 2018-03-22 |
| 1245746213 | Chicagoland University Pediatric Surgery, LLC | Surgery | 2900 N Lake Shore Dr, Chicago, IL 60657-5640 | 2017-12-28 |
| 1043655285 | Frances Chinenye Okolo | Surgery | 5841 S Maryland Ave # Mc4062, Chicago, IL 60637-1443 | 2013-05-01 |
| 1417226952 | Andrea Yan-sin Lo | Surgery | 5839 S Maryland Ave, Wp C-411 / Mc 4062, Chicago, IL 60637-1463 | 2011-12-28 |
| 1235441429 | Jennifer Rose Defazio | Surgery | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2010-07-05 |
| 1417198318 | Mark Slidell | Surgery | 5841 S Maryland Ave, M/c 4062 C411, Chicago, IL 60637-1447 | 2009-03-23 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.