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Individual

KEVIN MADERE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6825 W ADDISON ST, CHICAGO, IL 60634-3702
(773) 736-6610
Mailing address
6825 W ADDISON ST, CHICAGO, IL 60634-3702

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019035458
IL
122300000X
Dentist
Primary
6001208-15
WI

Other

Enumeration date
06/26/2023
Last updated
07/14/2026
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