MEDICARE: MAEDKE CHIROPRACTIC CENTER

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

General Provider Information

NPI Number	:	1619761533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAEDKE CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	3064 S KINNICKINNIC AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-2966
Country	:	US
Telephone Number	:	414-747-8822
Fax Number	:	414-747-8829

Provider Business Practice Location Address
First Line	:	3064 S KINNICKINNIC AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-2966
Country	:	US
Telephone Number	:	414-747-8822
Fax Number	:	414-747-8822

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	ANNE K MAEDKE
Credential	:	DC
Telephone Number	:	414-747-8822

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	04/07/2025

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