Organization
MAGGIOLINO MEDICAL, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY DANA FOGGETTI DO (PRESIDENT)
(630) 514-9297
Entity
Organization
Contact information
Practice address
840 S WAUKEGAN RD STE 102, LAKE FOREST, IL 60045-2616
(630) 514-9297
Mailing address
840 S WAUKEGAN RD STE 102, LAKE FOREST, IL 60045-2616
(630) 514-9297
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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