Provider Demographics
NPI:1467615328
Name:JOSEPH T MONACO MD SC
Entity Type:Organization
Organization Name:JOSEPH T MONACO MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-834-7200
Mailing Address - Street 1:16750 80TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-3173
Mailing Address - Country:US
Mailing Address - Phone:815-834-7200
Mailing Address - Fax:815-834-1307
Practice Address - Street 1:16750 80TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-3173
Practice Address - Country:US
Practice Address - Phone:708-444-1880
Practice Address - Fax:815-834-1307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036047704207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty