Provider Demographics
NPI:1710402342
Name:LIMONI, MADELYN SCHRICKER (DPT)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:SCHRICKER
Last Name:LIMONI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MADELYN
Other - Middle Name:
Other - Last Name:SCHRICKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7878 N 76TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-3914
Practice Address - Country:US
Practice Address - Phone:414-586-5710
Practice Address - Fax:414-586-5740
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211365225100000X
WI14776225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100185223Medicaid