Provider Demographics
NPI:1932322765
Name:ISAACS, MONIKA
Entity Type:Individual
Prefix:MS
First Name:MONIKA
Middle Name:
Last Name:ISAACS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 SHERIDAN ROAD
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1801
Mailing Address - Country:US
Mailing Address - Phone:773-724-0386
Mailing Address - Fax:
Practice Address - Street 1:171 E 84TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2000
Practice Address - Country:US
Practice Address - Phone:212-327-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029050-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist