Provider Demographics
NPI:1992715536
Name:MADVIG, MARGARET A (LSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:MADVIG
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S NAPERVILLE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-8155
Mailing Address - Country:US
Mailing Address - Phone:630-462-7005
Mailing Address - Fax:630-462-7006
Practice Address - Street 1:1725 S NAPERVILLE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-8155
Practice Address - Country:US
Practice Address - Phone:630-462-7005
Practice Address - Fax:630-462-7006
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker