NPIMap

Organization Active NPI

Integrated Health of Milwaukee LLC

  • Nutrition Chiropractor
  • Wauwatosa, WI
National Provider Identifier
1174906168
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
4606-012 Issued in WI
Legal business name
INTEGRATED HEALTH OF MILWAUKEE LLC
Practice address
2323 N Mayfair Rd
Suite 104
Wauwatosa, WI 53226-1506
Phone
(414) 837-4468
Fax
(414) 837-4212
NPI assigned
Jul 8, 2015
Last updated
Aug 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gregory Bonikowske, D.C.NPI 1700116233
Title
Owner
Phone
(414) 837-4468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 4606-012 WI Primary

Addresses

Primary practice location

2323 N Mayfair Rd
Suite 104
Wauwatosa, WI 53226-1506

Mailing address

2323 N Mayfair Rd
Suite 104
Wauwatosa, WI 53226-1506
Phone (414) 837-4468

Other identifiers 1

IdentifierTypeStateIssuer
1700116233MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1174906168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 N MAYFAIR RD",
            "address_2": "SUITE 104",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261506",
            "telephone_number": "414-837-4468",
            "fax_number": "414-837-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 N MAYFAIR RD",
            "address_2": "SUITE 104",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261506",
            "telephone_number": "414-837-4468",
            "fax_number": "414-837-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH OF MILWAUKEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "BONIKOWSKE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-837-4468",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "WI",
            "license": "4606-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700116233",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.