Individual
MADELINE A VAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Mailing address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209021774
IL
363LF0000X
Family Nurse Practitioner
209021774
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209021774
—
IL
01
—
MV8434146
DEA
IL
Enumeration date
09/27/2021
Last updated
11/13/2023
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