Provider Demographics
NPI:1073865697
Name:ABRAMS, MADELINE ROSE (PA-C)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:ROSE
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:2051 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-1865
Practice Address - Country:US
Practice Address - Phone:815-741-4343
Practice Address - Fax:815-741-8660
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2021-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085.004410363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant