Provider Demographics
NPI:1093393308
Name:SESSELMANN, MADELINE (DO)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:SESSELMANN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 N MILWAUKEE AVE STE 19
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3239
Mailing Address - Country:US
Mailing Address - Phone:847-318-9595
Mailing Address - Fax:847-318-9599
Practice Address - Street 1:7900 N MILWAUKEE AVE STE 19
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3239
Practice Address - Country:US
Practice Address - Phone:847-318-9595
Practice Address - Fax:847-318-9599
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.077980207R00000X
IL036.168573207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine