MEDICARE: MRS. MONIQUE JOBE

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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972249241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONIQUE JOBE

Provider Business Mailing Address
First Line	:	5739 N 98TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53225-2507
Country	:	US
Telephone Number	:	414-340-1477
Fax Number	:	414-677-7499

Provider Business Practice Location Address
First Line	:	5739 N 98TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53225-2507
Country	:	US
Telephone Number	:	414-736-0003
Fax Number	:

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

Provider Enumeration Date	:	05/10/2022
Last Update Date	:	12/11/2025

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