Madugula, Madhavi
Madugula, Madhavi is an individual health care provider with primary practice located at 2200 Fort Jesse Rd Suite 110, Normal IL 61761-6286. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Madugula, Madhavi can be contacted via phone (309) 661-6290.Contact Information
Primary practice address
2200 Fort Jesse Rd Suite 110
Normal IL 61761-6286
Phone: (309) 661-6290
Fax: (309) 451-1354
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4301085702 | Michigan |
Profile Details
| NPI number | 1144266065 |
|---|---|
| LBN Legal business name | Madugula, Madhavi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Dec 17th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144266065 | NPPES |
| Other | P00690231 | RR MEDICARE INDIVIDUAL # | |
| Other | CA2264 | RR MEDICARE INDIVIDUAL # | |
| MEDICAID | 036121987 | RR MEDICARE INDIVIDUAL # | |
| MEDICAID | 4769673 | RR MEDICARE INDIVIDUAL # | |
| Other | 833120 | RR MEDICARE INDIVIDUAL # |
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