Provider Demographics
NPI:1437120581
Name:MONROE, STEPHANIE M (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:M
Last Name:MONROE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:BUHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3302 GODFREY RD
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-2558
Mailing Address - Country:US
Mailing Address - Phone:618-467-2744
Mailing Address - Fax:618-467-2753
Practice Address - Street 1:3302 GODFREY RD
Practice Address - Street 2:
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035-2558
Practice Address - Country:US
Practice Address - Phone:618-467-2744
Practice Address - Fax:618-467-2753
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL293662OtherHEALTHLINK
IL06021571OtherBLUE CROSS BLUE SHEILD
MO105211OtherMO BLUE CROSS BLUE SHEILD
IL4400408OtherUNITED HEALTH CARE
IL5178160OtherAETNA
IL293662OtherHEALTHLINK
MO105211OtherMO BLUE CROSS BLUE SHEILD