Provider Demographics
NPI:1265216972
Name:DARROW, MADISON RAY I (RDN)
Entity type:Individual
Prefix:MISS
First Name:MADISON
Middle Name:RAY
Last Name:DARROW
Suffix:I
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2600
Mailing Address - Country:US
Mailing Address - Phone:217-214-5800
Mailing Address - Fax:
Practice Address - Street 1:1107 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2600
Practice Address - Country:US
Practice Address - Phone:217-214-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.009257133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered