Provider Demographics
NPI:1144802596
Name:MADONIA, JOSEPH S (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:MADONIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 RANDALL RD STE LL10
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4205
Mailing Address - Country:US
Mailing Address - Phone:630-933-6803
Mailing Address - Fax:
Practice Address - Street 1:302 RANDALL RD STE LL10
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4205
Practice Address - Country:US
Practice Address - Phone:630-933-6803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070020944225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty