Provider Demographics
NPI:1487659819
Name:MAEDKE, ANNE K (DC DABCI)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:K
Last Name:MAEDKE
Suffix:
Gender:F
Credentials:DC DABCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2782 S WENTWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2354
Mailing Address - Country:US
Mailing Address - Phone:414-483-8093
Mailing Address - Fax:
Practice Address - Street 1:715 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-2546
Practice Address - Country:US
Practice Address - Phone:414-263-7066
Practice Address - Fax:414-263-2688
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1823111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38779100Medicaid
WI38779100Medicaid