Individual
DORIS MADRIGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1228 N CEDAR LAKE RD, SUITE C, ROUND LAKE BEACH, IL 60073-2556
(847) 740-8827
(847) 740-7388
Mailing address
187 N CROOKED LAKE LANE, LINDENHURST, IL 60046-6438
(847) 265-8539
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-0227620
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002800-102967
—
IL
Enumeration date
09/01/2006
Last updated
10/01/2008
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