Individual
MADISON STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3333 GREEN BAY RD, NORTH CHICAGO, IL 60064-3037
(937) 414-1002
Mailing address
3333 GREEN BAY RD, NORTH CHICAGO, IL 60064-3037
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041495363
IL
163W00000X
Registered Nurse
1104641-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
209032499
IL
Other
Enumeration date
08/24/2023
Last updated
07/25/2025
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