Basic Information
Provider Information
NPI: 1699406819
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RINGER
FirstName: MADELINE
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: D.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 78534
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532788534
CountryCode: US
TelephoneNumber: 8153989491
FaxNumber: 8153817498
Practice Location
Address1: 12376 PRINCETON DR
Address2:  
City: HUNTLEY
State: IL
PostalCode: 601427655
CountryCode: US
TelephoneNumber: 8153989491
FaxNumber: 8153817498
Other Information
ProviderEnumerationDate: 06/20/2022
LastUpdateDate: 09/13/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X070026880ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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