Provider Demographics
NPI:1891316279
Name:CHAPMAN, MADELYN GAIL (MSN, RN, LMT)
Entity Type:Individual
Prefix:MRS
First Name:MADELYN
Middle Name:GAIL
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:MSN, RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7811 N ALPINE RD STE 112
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-3196
Mailing Address - Country:US
Mailing Address - Phone:779-207-2887
Mailing Address - Fax:
Practice Address - Street 1:7811 N ALPINE RD STE 112
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-3196
Practice Address - Country:US
Practice Address - Phone:779-207-2887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.325233163W00000X
IL227.021062225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No163W00000XNursing Service ProvidersRegistered Nurse