MEDICARE: DR. JOSEPH SHUKRI MAKHLOUF II D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3530	WI

General Provider Information

NPI Number	:	1255496246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH SHUKRI MAKHLOUF II D.C.

Provider Business Mailing Address
First Line	:	772 N 116TH ST
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-3613
Country	:	US
Telephone Number	:	414-453-9914
Fax Number	:

Provider Business Practice Location Address
First Line	:	5310 W CAPITOL DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-2263
Country	:	US
Telephone Number	:	414-431-1580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	07/08/2007

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