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Jini Xavier Madathil

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

680 Kylemore Dr, Des Plaines, IL 60016-8712

PECOS Enrollment

This provider is enrolled in PECOS as JINI MADATHIL.

Based on the most recent information from CMS, provider Jini Xavier Madathil is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1811544042
Provider Type
Individual
Full Name
Madathil, Jini Xavier
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
8/22/2019
Last Updated
8/22/2019

Contact Information

Practice Location

680 Kylemore Dr, Des Plaines, IL 60016-8712

(847) 660-3548

Unlisted Fax

Mailing Location

680 Kylemore Dr, Des Plaines, IL 60016-8712

(847) 660-3548

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 209.019360 Illinois

Jini Xavier Madathil

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Patel, Payal

Wisniewski, Lisa Jane

Lopez, Jenice

Vasquez, Kelly Marie

Patel, Dipa Dramin

Compassionate Provider Services Inc

Joy, Ansha

Thomas, Keziah M.

Patel, Denise

Joseph, Tina