Doctor Name: | MADHU B JAIN |
NPI Number: | 1003924796 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 036061831 |
Business Practice Address: | 7530 S Woodward Ave Ste A Woodridge Clinic S.c. Woodridge, IL - 605173100 |
Business Phone Number: | 6309101177 |
Business Fax Number: | 6309101177 |
Mailing Address: | 7530 S Woodward Ave Ste A, Woodridge Clinic S.c. WOODRIDGE |
State: | IL |
Postal Code: | 605173100 |
Phone Number: | 6309101177 |
Fax Number: | 6309101177 |
NPI Enumeration Date: | 08/25/2006 |
NPI Last Update Date: | 05/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207KA0200X |
License Number: | 036061831 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Allergy & Immunology |
Taxonomy Specialization: | Allergy |
Taxonomy Definition: |