Individual
MADISON MAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3808 N ASHLAND AVE, CHICAGO, IL 60613-5382
(312) 217-5887
Mailing address
3808 N ASHLAND AVE, CHICAGO, IL 60613-5382
(312) 217-5887
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178016225
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
474726722
PRIVATE INSURANCE
IL
Enumeration date
11/30/2021
Last updated
03/27/2024
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