OrganizationMadamba Medical Associates ScObstetrics & GynecologyAllopathic & Osteopathic PhysiciansPractice Address1431 N Western Ave, Suite 203, Chicago, IL 60622-1797(773) 278-1222(773) 463-3632PECOS EnrollmentBased on the most recent information from CMS, provider Madamba Medical Associates Sc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1659529162Provider TypeOrganizationFull NameMadamba Medical Associates ScSubpartNoEnumeration Date9/9/2008Last Updated9/21/2012Contact InformationPractice LocationPractice Address1431 N Western Ave, Suite 203, Chicago, IL 60622-1797Phone(773) 278-1222Fax(773) 278-4598Mailing LocationMailing Address5332 N Kildare Ave, Chicago, IL 60630-1759Phone(773) 463-3632Fax(773) 278-4598Authorized OfficialNameMadamba, Eduardo N (President)Phone(773) 463-3632Provider TaxonomiesCodeDescriptionLicenseCode207V00000XPrimaryDescriptionObstetrics & GynecologyAllopathic & Osteopathic PhysiciansLicense336014028IllinoisProvider IdentifiersIDDescriptionIssuerID0021604377DescriptionOtherIssuerBLUE CROSS BLUE SHIELD OF ILLINOISIllinoisID036047978DescriptionMedicaidIssuerUnlistedIllinois