Provider Demographics
NPI:1700925963
Name:MADDA, FRANK C (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:C
Last Name:MADDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 BARRINGTON RD
Mailing Address - Street 2:STE 601
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5020
Mailing Address - Country:US
Mailing Address - Phone:847-755-1000
Mailing Address - Fax:847-843-7793
Practice Address - Street 1:1585 BARRINGTON RD
Practice Address - Street 2:601
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-1090
Practice Address - Country:US
Practice Address - Phone:847-755-1000
Practice Address - Fax:847-843-7793
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036051982174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL726580Medicare ID - Type UnspecifiedFRANK C MADDA
ILC42676Medicare UPIN