Healthcare Provider Details

I. General information

NPI: 1487659819
Provider Name (Legal Business Name): ANNE K MAEDKE DC DABCI
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 07/09/2007
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

2782 S WENTWORTH AVE
MILWAUKEE WI
53207-2354
US

V. Phone/Fax

Practice location:
  • Phone: 414-263-7066
  • Fax: 414-263-2688
Mailing address:
  • Phone: 414-483-8093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number1823
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: