MEDICARE: JOSEPH T MONACO MD SC

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	207X00000X	Orthopaedic Surgery Physician	036047704	IL

General Provider Information

NPI Number	:	1467615328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH T MONACO MD SC

Provider Business Mailing Address
First Line	:	16750 80TH AVE
Second Line	:	SUITE A
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-3173
Country	:	US
Telephone Number	:	815-834-7200
Fax Number	:	815-834-1307

Provider Business Practice Location Address
First Line	:	16750 80TH AVE
Second Line	:	SUITE A
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-3173
Country	:	US
Telephone Number	:	708-444-1880
Fax Number	:	815-834-1307

Authorized Official
Title or Position	:	MANAGER
Name	:	LISA RYAN
Credential	:
Telephone Number	:	815-834-7200

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	08/08/2011

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