| Ajay A Madhani Md Sc | |
|
755 S Milwaukee Ave Suite 263 Libertyville IL 60048-3253 | |
| (847) 367-0787 | |
| Not Available |
| Full Name | Ajay A Madhani Md Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 755 S Milwaukee Ave, Libertyville, Illinois |
| Authorized Official Name and Position | Ajay A Madhani (PRESIDENT) |
| Authorized Official Contact | 8476423781 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ajay A Madhani Md Sc 200 Southfield Dr Vernon Hills IL 60061-3209 Ph: (847) 642-3781 | Ajay A Madhani Md Sc 755 S Milwaukee Ave Suite 263 Libertyville IL 60048-3253 Ph: (847) 367-0787 |
| NPI Number | 1962567651 |
|---|---|
| Provider Enumeration Date | 12/25/2006 |
| Last Update Date | 12/31/2021 |
| Medicare PECOS PAC ID | 8224296462 |
|---|---|
| Medicare Enrollment ID | O20120220000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962567651 | NPI | - | NPPES |
| 087144 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 042 007596 (Illinois) | Primary |
| Provider Name | Ajay A Madhani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841271947 PECOS PAC ID: 1254333719 Enrollment ID: I20100707000143 |
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