Healthcare Provider Details

I. General information

NPI: 1356515134
Provider Name (Legal Business Name): ANNE MAEDKE, DC DABCI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E LOCUST ST
MILWAUKEE WI
53212-2546
US

IV. Provider business mailing address

715 E LOCUST ST
MILWAUKEE WI
53212-2546
US

V. Phone/Fax

Practice location:
  • Phone: 414-263-7066
  • Fax: 414-263-2688
Mailing address:
  • Phone: 414-263-7066
  • Fax: 414-263-2688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4119-012
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number1823-012
License Number StateWI

VIII. Authorized Official

Name: DR. ANNE K MAEDKE
Title or Position: DOCTOR
Credential: DC DABCI
Phone: 414-263-7066