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NPI Code Detail

MEDICARE: JULIE CHICKS, M.D., S.C.

MEDICARE: JULIE CHICKS, M.D., S.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
1207R00000XInternal Medicine Physician40099WI

General Provider Information

NPI Number : 1316997034
Entity Type Code : Organization
Provider Name (Legal Business Name) : JULIE CHICKS, M.D., S.C.
Provider Business Mailing Address
First Line : 4922 COLUMBIA RD
Second Line :
City : CEDARBURG
State : WI
Zip : 53012-9188
Country : US
Telephone Number : 262-375-1580
Fax Number : 262-375-9452
Provider Business Practice Location Address
First Line : 4922 COLUMBIA RD
Second Line :
City : CEDARBURG
State : WI
Zip : 53012-9188
Country : US
Telephone Number : 262-375-1580
Fax Number : 262-375-9452
Authorized Official
Title or Position : PRESIDENT
Name : JULIE CHICKS
Credential : M.D.
Telephone Number : 262-375-1580
Provider Enumeration Date : 05/11/2006
Last Update Date : 01/12/2009

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