Mary Inez Nunchuck, D.O.

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

377260021 Issued in WI

Practice address

1717 Taylor Ave
Racine, WI 53403-2405

Phone

(262) 638-6744

Fax

(262) 638-6540

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aalto Enhancement Center, S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kenosha, WI
  • NPI 1629155973
  NPD (past)
• Horizon Healthcare, Inc

  • Mental Health Counselor
  • Greenfield, WI
  • NPI 1043234628
  NPD (past)
• Horizon Healthcare, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1225052830
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1316028616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032405",
            "telephone_number": "262-638-6744",
            "fax_number": "262-638-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032405",
            "telephone_number": "262-638-6744",
            "fax_number": "262-638-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNCHUCK",
        "first_name": "MARY",
        "middle_name": "INEZ",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "WI",
            "license": "377260021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeleine Elizabeth Norton, CCC-SLP
• Susan Nosalik, NP
• Jason Novak, PHARMD
• Chad M Novasic, PT
• Kimberly Nowak, PT
• Catalina Fransisca Nuno
• Nurturing Hearts Homecare LLC
• Nutritional Designs LLC
• Nvira Genetics LLC
• Maureen Elizabeth O'Brien, RN

• Addiction Psychiatry Physician in Racine, WI
• Providers in Racine, WI by specialty
• Addiction Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.