# AJAY A MADHANI MD SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962567651
- **Authorized official:** DR. AJAY A MADHANI MD (PRESIDENT)
- **Authorized official phone:** (847) 642-3781

## Contact information

- **Practice address:** 755 S MILWAUKEE AVE, SUITE 263, LIBERTYVILLE, IL 60048-3253
- **Practice address phone:** (847) 367-0787
- **Mailing address:** 200 SOUTHFIELD DR, VERNON HILLS, IL 60061-3209
- **Mailing address phone:** (847) 642-3781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 042 007596 | IL | Yes |

## Other

- **Enumeration date:** 12/25/2006
- **Last updated:** 12/31/2021