Provider Demographics
NPI:1972547990
Name:SAXENA, MADHULIKA (MD)
Entity type:Individual
Prefix:DR
First Name:MADHULIKA
Middle Name:
Last Name:SAXENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60454-0626
Mailing Address - Country:US
Mailing Address - Phone:708-422-9577
Mailing Address - Fax:708-422-8101
Practice Address - Street 1:5331 W 79TH ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-3500
Practice Address - Country:US
Practice Address - Phone:708-422-9577
Practice Address - Fax:708-422-8101
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098524207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036098524Medicaid
IL553930Medicare ID - Type Unspecified
IL036098524Medicaid