Provider Demographics
NPI:1558398370
Name:MONACO, JOSEPH THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:MONACO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16750 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:708-444-1880
Mailing Address - Fax:708-444-1980
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:708-444-1980
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL491651Medicare ID - Type Unspecified
ILD13117Medicare UPIN