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NPI Code Detail

MEDICARE: STEPHANIE M MONROE D.C., P.C.

MEDICARE: STEPHANIE M MONROE D.C., P.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
1111N00000XChiropractorIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1293662OTHERILHEALTHLINK
206021571OTHERINBLUE CROSS BLUE SHIELD IL
34400408OTHERILUHC
4105211OTHERMOBLUE SHIELD OF MO
55178160OTHERILAETNA

General Provider Information

NPI Number : 1982743126
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEPHANIE M MONROE D.C., P.C.
Provider Business Mailing Address
First Line : 3302 GODFREY RD
Second Line :
City : GODFREY
State : IL
Zip : 62035-2558
Country : US
Telephone Number : 618-467-2744
Fax Number :
Provider Business Practice Location Address
First Line : 3302 GODFREY RD
Second Line :
City : GODFREY
State : IL
Zip : 62035-2558
Country : US
Telephone Number : 618-467-2744
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEPHANIE M MONROE
Credential : D.C.
Telephone Number : 618-467-2744
Provider Enumeration Date : 02/05/2007
Last Update Date : 11/14/2007

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