MARY INEZ NUNCHUCK


Address: 1717 Taylor Ave, Racine, WI 53403-2405
Phone: 2626386744

MARY INEZ NUNCHUCK (NPI# 1316028616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316028616
Entity Type Individual
Full Name MARY INEZ NUNCHUCK
Credential D.O.
Practice Address 1717 Taylor Ave
Racine
WI 53403-2405
Practice Telephone 2626386744
Practice Fax Number 2626386540
Mailing Telephone 2626386744
Mailing Fax Number 2626386540
Enumeration Date 2006-10-17
Last Update Date 2020-07-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0802X Psychiatry & Neurology
Specialization: Addiction Psychiatry
377260021 WI Allopathic & Osteopathic Physicians

Office Location

Street Address 1717 TAYLOR AVE
City RACINE
State WI
Zip Code 53403-2405

Providers in the same location

NPI Name Taxonomy Address Enumeration
1356441018 Susan F Mickel Psychologist 1717 Taylor Ave, Racine, WI 53403-2405 2006-09-23
1811595671 Wallace Edward Brandies Jr. Counselor 1717 Taylor Ave, Racine, WI 53403-2405 2020-10-14
1811503204 Sarah Moran Counselor 1717 Taylor Ave, Racine, WI 53403-2405 2020-09-21
1013539477 Kelly Jean Smith Counselor 1717 Taylor Ave, Racine, WI 53403-2405 2020-05-08
1417577230 Alexandra Kim Kies Social Worker 1717 Taylor Ave, Racine, WI 53403-2405 2020-04-22
1336785336 Selena Lamont Letteer Counselor 1717 Taylor Ave, Racine, WI 53403-2405 2019-11-25
1841832474 Dora Ann Caldwell Counselor 1717 Taylor Ave, Racine, WI 53403-2405 2019-10-15
1043876451 Darren L Taylor Counselor 1717 Taylor Ave, Racine, WI 53403-2405 2019-05-13
1689230179 Kathleen B Campeau Counselor 1717 Taylor Ave, Racine, WI 53403-2405 2019-05-10
1689131534 Melissa Hellen Social Worker 1717 Taylor Ave, Racine, WI 53403-2405 2019-02-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124676259 Quality Care LLC Clinic/Center 2051 Mead St, Racine, WI 53403 2019-09-02
1073999355 Wisconsin Lutheran Child & Family Service, Inc. Social Worker 6150 Taylor Avenue, Racine, WI 53403 2015-08-10
1457780496 Pheynell Branch Counselor 1650 Wasington Ave, Racine, WI 53403 2013-11-08
1811278054 Michelle Gloria Parisot Psychologist 1320 Wisconsin Ave., Racine, WI 53403 2011-09-01
1720372022 Katie Hagen Social Worker 1717 Taylor Avenue, Racine, WI 53403 2011-06-03
1043431570 Rita S Harris Physical Therapy Assistant Lakeshore Manor 1320 Wisconsin Avenue, Racine, WI 53403 2007-05-01
1336281336 Linda J Hockensmith Occupational Therapist 4214 Sheridan Road, Racine, WI 53403 2007-02-13
1851447387 Richard John Kemper Dentist 1509 Washington Ave, Racine, WI 53403 2007-01-26
1689760332 Lester Leslie Higgenbottom Counselor 1820 Arlington Ave, Racine, WI 53403 2006-10-04
1114942315 Access Medical Center, LLC Clinic/Center 4216 Old Green Bay Rd, Racine, WI 53403 2006-07-12
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Taxonomy Information

Taxonomy Code 2084P0802X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Addiction Psychiatry

Taxonomy Definition

Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1790837128 Milwaukee Health Services System, LLC Psychiatry & Neurology 4800 S. 10th Street, Milwaukee, WI 53221-2412 2007-01-17
1164432118 Tellurian, Inc. Psychiatry & Neurology 1053 Williamson St, Madison, WI 53703-3525 2006-08-09
1114377702 Valdez & Soto, LLC Psychiatry & Neurology 1001 Cecelia Dr Ste 200, Pewaukee, WI 53072-2546 2016-06-15
1487018834 Bryan Hybki Psychiatry & Neurology Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792-1000 2016-04-12
1588921696 Mohammed Abbas Rahemtulla Psychiatry & Neurology 903 Mineral Point Ave, Janesville, WI 53548-2970 2012-04-13
1285672360 Virginia M. Linabury Psychiatry & Neurology 250 W Coventry Ct, Suite 209, Glendale, WI 53217-3972 2006-06-02
1235109638 Carolyn Jean Reabe Psychiatry & Neurology 3425 Superior Ave, Sheboygan, WI 53081-1863 2006-01-26

Competitor

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City RACINE
Zip Code 53403

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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