Provider Demographics
NPI:1831815455
Name:HUGUNIN, MADELYNN JANE
Entity type:Individual
Prefix:
First Name:MADELYNN
Middle Name:JANE
Last Name:HUGUNIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25227 W MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-3309
Mailing Address - Country:US
Mailing Address - Phone:708-870-7217
Mailing Address - Fax:
Practice Address - Street 1:25227 W MEADOWLARK DR
Practice Address - Street 2:
Practice Address - City:CHANNAHON
Practice Address - State:IL
Practice Address - Zip Code:60410-3309
Practice Address - Country:US
Practice Address - Phone:708-870-7217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician