Individual
DANA MARIE MADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-8323
(262) 948-5600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
8159-23
WI
363A00000X
Physician Assistant
Primary
8159-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100304294
—
WI
Enumeration date
11/19/2024
Last updated
02/25/2025
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