Individual
MADDALENA FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 N MAIN ST, ROANOKE, IL 61561-7585
(309) 923-2661
Mailing address
2970 BRIARWOOD LN, TITUSVILLE, FL 32796-1689
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.011960
IL
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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