Organization
AJAY A MADHANI MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJAY A MADHANI MD (PRESIDENT)
(847) 642-3781
Entity
Organization
Contact information
Practice address
755 S MILWAUKEE AVE, SUITE 263, LIBERTYVILLE, IL 60048-3253
(847) 367-0787
Mailing address
200 SOUTHFIELD DR, VERNON HILLS, IL 60061-3209
(847) 642-3781
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042 007596
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087144
—
IL
Enumeration date
12/25/2006
Last updated
12/31/2021
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