| Doctor Name: | REBECCA GRACE MADDRELL |
| NPI Number: | 1811344567 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 1 Erie Court, Suite 6160 Dr. A.l. Burdick Family Medicine Center Oak Park, IL - 603022519 |
| Business Phone Number: | 7087631490 |
| Business Fax Number: | 7087637232 |
| Mailing Address: | 1 Erie Court, Suite 6160, Dr. A.l. Burdick Family Medicine Center OAK PARK |
| State: | IL |
| Postal Code: | 603022519 |
| Phone Number: | 7087631490 |
| Fax Number: | 7087637232 |
| NPI Enumeration Date: | 05/23/2016 |
| NPI Last Update Date: | 05/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |