Provider Demographics
NPI:1467552745
Name:MARONEY, MONICA E (DC, DICCP)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:E
Last Name:MARONEY
Suffix:
Gender:F
Credentials:DC, DICCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-1611
Mailing Address - Country:US
Mailing Address - Phone:414-962-5483
Mailing Address - Fax:414-962-5482
Practice Address - Street 1:4433 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-1611
Practice Address - Country:US
Practice Address - Phone:414-962-5483
Practice Address - Fax:414-962-5482
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3821-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI04-3713163OtherFEDERAL ID NUMBER
WI38940700Medicaid
WI35444Medicare ID - Type Unspecified
WI38940700Medicaid