Provider Demographics
NPI:1497700959
Name:NEEMS, MADELEINE (MD)
Entity Type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:
Last Name:NEEMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 FIRST STREET
Mailing Address - Street 2:SUITE #300
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3236
Mailing Address - Country:US
Mailing Address - Phone:847-433-1800
Mailing Address - Fax:
Practice Address - Street 1:1770 FIRST STREET
Practice Address - Street 2:SUITE #300
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3236
Practice Address - Country:US
Practice Address - Phone:847-433-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036063396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209374OtherMEDICARE PRACTICE ID
IL14D1016269OtherCLIA #
IL036063396OtherIL PHYSICIAN LICENSE #
IL004932187OtherBCBS PROVIDER ID
IL209374OtherMEDICARE PRACTICE ID
ILK08057Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID