Individual
MADHU S SADAGOPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 E LAYTON AVE, ST FRANCIS, WI 53235-6053
(414) 744-6589
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 744-6589
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
44030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20640008
INS CERT
IL
05
—
34840100
—
WI
Enumeration date
05/15/2006
Last updated
10/04/2023
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