Virginia P Madla, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

036045010 Issued in IL

Practice address

2900 Foxfield Rd
Suite 206
St Charles, IL 60174-5799

Phone

(630) 584-6127

Fax

(630) 584-6070

NPI assigned

Jul 8, 2005

Reactivated

Mar 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25998/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dukane Allergy Associates. LTD

  • Preferred Provider Organization
  • St Charles, IL
  • NPI 1053503383
  Authorized official Same address or phone
• Hinsdale Asthma & Allergy Center SC

  • Allergy & Immunology Physician
  • Hinsdale, IL
  • NPI 1154400331
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427056092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD",
            "address_2": "SUITE 206",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "630-584-6127",
            "fax_number": "630-584-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD",
            "address_2": "SUITE 206",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "630-584-6127",
            "fax_number": "630-584-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADLA",
        "first_name": "VIRGINIA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036045010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki M Lutzow, P.T.
• Luxottica of America Inc (Target Optical #4321)
• Luxottica Retail North America Inc (Sears Optical #C1006)
• Alexa Rae Lyons
• Angella Macdonald, LMFT
• Alyssa M Madonia, BCBA
• Mary Madsen-Heskin, M.A.
• Maegan Jenkins PSYD PLLC
• Maegan Jenkins PSYD PLLC
• Jason Magafas, PTA

• Allergy & Immunology Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• Allergy & Immunology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.