Provider Demographics
NPI:1285324012
Name:MADERA, ESPERANCE MAFAR
Entity type:Individual
Prefix:MS
First Name:ESPERANCE
Middle Name:MAFAR
Last Name:MADERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SOUTH FAIRFIELD AVE, MOUNT SINAI HOSPITAL
Mailing Address - Street 2:F-914
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608
Mailing Address - Country:US
Mailing Address - Phone:773-257-5914
Mailing Address - Fax:773-257-6027
Practice Address - Street 1:1500 SOUTH FAIRFIELD AVE, MOUNT SINAI HOSPITAL
Practice Address - Street 2:F-914
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608
Practice Address - Country:US
Practice Address - Phone:773-257-5914
Practice Address - Fax:773-257-6027
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty