Madamba Medical Associates SC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

336014028 Issued in IL

Legal business name

MADAMBA MEDICAL ASSOCIATES SC

Practice address

1431 N Western Ave
Suite 203
Chicago, IL 60622-1797

Phone

(773) 278-1222

Fax

(773) 278-4598

NPI assigned

Sep 9, 2008

Organization subpart

No

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

Authorized official

Name

Eduardo N Madamba, MD

Title

President

Phone

(773) 463-3632

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348185600000",
    "number": "1659529162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5332 N KILDARE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301759",
            "telephone_number": "773-463-3632",
            "fax_number": "773-278-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE",
            "address_2": "SUITE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221797",
            "telephone_number": "773-278-1222",
            "fax_number": "773-278-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADAMBA MEDICAL ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2012-09-21",
        "status": "A",
        "authorized_official_last_name": "MADAMBA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-463-3632",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "336014028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ILLINOIS",
            "identifier": "0021604377",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047978",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Lea Macy, MD
• Samuel Thomas Macy, PSYD
• Jo Anne Maczulski, OTR L
• Shreshtha Madaan, M.S.
• Inderpreet Kaur Madahar, MD
• Luningning Gayapa Madamba, MD
• Harsha Vardhan Hampasandra Madan Kumar, MD
• Kajal Madan, MD
• Mehak Madan
• Neha A Madangarli, MD

• Obstetrics & Gynecology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.