Healthcare Provider Details

I. General information

NPI: 1558398370
Provider Name (Legal Business Name): JOSEPH THOMAS MONACO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16750 80TH AVE SUITE A
TINLEY PARK IL
60477-3173
US

IV. Provider business mailing address

16750 80TH AVE SUITE A
TINLEY PARK IL
60477-3173
US

V. Phone/Fax

Practice location:
  • Phone: 708-444-1880
  • Fax: 708-444-1980
Mailing address:
  • Phone: 708-444-1880
  • Fax: 708-444-1980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: