Individual
MADHURI DAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5354
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-4874
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
66579
WI
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
036-161196
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497140040
—
WI
Enumeration date
03/31/2015
Last updated
10/13/2022
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