Provider Demographics
NPI:1346243326
Name:HOWARD, MONIQUE MARIA (MD)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:MARIA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W. PARK STREET
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2500
Mailing Address - Country:US
Mailing Address - Phone:217-383-6792
Mailing Address - Fax:217-383-4752
Practice Address - Street 1:311 W. FAIRCHILD STREET
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-3803
Practice Address - Country:US
Practice Address - Phone:217-431-7900
Practice Address - Fax:217-431-7634
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY297102080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64067259Medicaid
KY64067259Medicaid
B01043Medicare UPIN