Ichchha Madan
Obstetrics & Gynecology

Address: 3990 John R St, Mail Box 4, Detroit, MI 48201-2018
Phone: 3135770292

Ichchha Madan (NPI# 1982862926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1982862926
Entity Type Individual
Full Name Ichchha Madan
Credential M.D.
Gender Female
Practice Address 3990 John R St
Mail Box 4
Detroit
MI 48201-2018
Practice Telephone 3135770292
Practice Fax Number 3135778986
Mailing Address 3990 John R St
Mail Box 4
Detroit
MI 48201-2018
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2008-05-27
Last Update Date 2009-07-07

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207V00000X Obstetrics & Gynecology Allopathic & Osteopathic Physicians 4301091439 MI

Other Provider Identifier

State Identifier Issuer Type Code
MI 1982862926 MEDICAID

Physician Overview

NPI 1982862926
PAC ID by PECOS 1951476076
Professional Enrollment ID I20080823000093
Full Name Ichchha Madan
Organization Legal Name BEAUMONT MEDICAL GROUP SPECIALTY SERVICES
Phone Number 2487124120
Gender F
Graduation Year 2001
Primary Specialty OBSTETRICS/GYNECOLOGY
Group Practice PAC ID 7214299866
Number of Group Practice Members 312
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Office Location

Street Address 3990 JOHN R ST
MAIL BOX 4
City DETROIT
State MI
Zip Code 48201-2018

Providers in the same location

NPI Name Taxonomy Address Enumeration
1669720835 Samer Alsamman Internal Medicine 3990 John R St, 3 Hudson. Division of Pulmonary Critical Care Medicine, Detroit, MI 48201-2018 2012-08-20
1487125209 Emily Janice Huskey Nurse Anesthetist, Certified Registered 3990 John R St, Detroit, MI 48201-2097 2018-12-06
1972079671 Alaina Renee Brouckaert Physician Assistant 3990 John R St, Detroit, MI 48201-2097 2018-10-19
1457833303 Tony Koehn Pharmacist 3990 John R St, Detroit, MI 48201-2018 2018-09-06
1588143291 Lejla Jakupovic Pharmacist 3990 John R St, Detroit, MI 48201-2018 2018-08-13
1720564867 Jessica Anne Montrief Registered Nurse 3990 John R St, Detroit, MI 48201-2018 2018-07-12
1235623034 Rebecca Michelle Sarkozi Pharmacist 3990 John R St, Detroit, MI 48201-2097 2018-06-15
1871086736 Kurt Michael Biebuyck Physical Therapist 3990 John R St, Detroit, MI 48201-2018 2018-06-14
1568955417 Joshua Sabes Physical Therapist 3990 John R St, Detroit, MI 48201-2018 2018-06-14
1659864569 Jennifer Nickita Physical Therapist 3990 John R St, Detroit, MI 48201-2018 2018-06-14
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851877799 Ali Sameh Ali Ayesh Student in an Organized Health Care Education/Training Program 4201 St., Antoine St., Detroit, MI 48201 2018-07-13
1194211417 Aysel Unal Student in an Organized Health Care Education/Training Program 540 E Canfied, 3311 Scott Hall, Detroit, MI 48201 2018-07-10
1285129221 Wayne State University Psychologist 540 E Canfield St Ste 1241, Detroit, MI 48201 2018-06-22
1710470109 Jason Carlo Roberts Physical Therapist 261 Mack, Detroit, MI 48201 2018-06-11
1235620626 Walgreen Co Pharmacy 3990 John R St Ste 1460, Detroit, MI 48201 2018-05-22
1063903458 Walgreen Co Durable Medical Equipment & Medical Supplies 4201 Saint Antoine St Ste 2m, Detroit, MI 48201 2018-05-22
1467943852 Walgreen Co Durable Medical Equipment & Medical Supplies 3901 Beaubien St Rm 108, Detroit, MI 48201 2018-05-22
1568950681 Sabreena Kammo Student in an Organized Health Care Education/Training Program 4201 St. Antoine, Uhc 9c, Detroit, MI 48201 2018-04-24
1972090298 Ahmad H Arabi Student in an Organized Health Care Education/Training Program Detroit Medical Center, Graduate Medical Education, 4201 St Antoine, Uhc 9c, Detroit, MI 48201 2018-04-23
1336636398 Motaz Samih Mustafa Alshami Student in an Organized Health Care Education/Training Program 3901 Chrysler Service Drive, Wsu Tolan Park Medical Bui, Suite 5-a, Detroit, MI 48201 2018-04-16
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Taxonomy Information

Taxonomy Code 207V00000X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology

Taxonomy Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1992009955 Maurice-andre Recanati Obstetrics & Gynecology 4201 Saint Antoine St Ste 4c, Detroit, MI 48201-2153 2011-01-06
1194041830 Eberechukwu Jill Azumah Obstetrics & Gynecology 5960 Bedford St, Detroit, MI 48224-2651 2010-04-19
1700040946 Laura Londra Obstetrics & Gynecology 3980 John R St, Detroit, MI 48201-2018 2008-07-16
1134383508 Haider S Mahdi Obstetrics & Gynecology 3990 John R, 7 Brush North, Wayne State University/ Detroit Medical Center,obgyn, Detroit, MI 48201 2008-07-15
1609040484 Yhfmc PC Obstetrics & Gynecology 15266 Grand River Ave, Detroit, MI 48227-2213 2008-04-14
1487846507 Manasi Sanjay Patwardhan Obstetrics & Gynecology 4201 St Antoine, Ste 4c, University Health Center, Detroit, MI 48201-2153 2007-08-13
1619191954 F Seabrooks Obstetrics & Gynecology 19305 W 7 Mile Rd, Detroit, MI 48219-2718 2007-04-11
1326168188 Mary Ibe Obstetrics & Gynecology 3980 John R, Detroit, MI 48201 2007-03-29
1144365545 George W Gibson Obstetrics & Gynecology 15201 W Mcnichols Rd, Detroit, MI 48235-3717 2007-02-21
1780764712 Romeo H Tabbilos Obstetrics & Gynecology 3011 West Grand Boulevard, Suite 428, Detroit, MI 48202 2006-10-16
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City DETROIT
Zip Code 48201

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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