NPIMap

Organization Active NPI

Maggiolino Medical, S.C.

  • Family Medicine Physician
  • Lake Forest, IL
National Provider Identifier
1760175129
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAGGIOLINO MEDICAL, S.C.
Practice address
840 S Waukegan Rd Ste 102
Lake Forest, IL 60045-2616
Phone
(630) 514-9297
NPI assigned
Jun 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Dr. Mary Dana Foggetti, DONPI 1578593257
Title
President
Phone
(630) 514-9297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

840 S Waukegan Rd Ste 102
Lake Forest, IL 60045-2616

Mailing address

840 S Waukegan Rd Ste 102
Lake Forest, IL 60045-2616
Phone (630) 514-9297

National Provider Directory

National Provider Directory
Tax ID family
Maggiolino Medical SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

436 W Frontage Rd
Northfield, IL 60093
Phone (847) 558-8888

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1760175129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WAUKEGAN RD STE 102",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452616",
            "telephone_number": "630-514-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WAUKEGAN RD STE 102",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452616",
            "telephone_number": "630-514-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGGIOLINO MEDICAL, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "FOGGETTI",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "DANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-514-9297",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.