Provider Demographics
NPI:1982494944
Name:PUGH, MADISON ANN (CF-SLP)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:ANN
Last Name:PUGH
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 W BELMONT AVE APT 701
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4786
Mailing Address - Country:US
Mailing Address - Phone:281-787-6828
Mailing Address - Fax:
Practice Address - Street 1:2339 N CALIFORNIA AVE UNIT 47949
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-0360
Practice Address - Country:US
Practice Address - Phone:312-458-9865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.008194235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist