Matejcek, Mary Jean

Matejcek, Mary Jean is an individual health care provider with primary practice located at 721 American Ave Suite 501, Waukesha WI 53188-5071. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Matejcek, Mary Jean can be contacted via phone (262) 928-2396.

Contact Information

Primary practice address
721 American Ave Suite 501 Waukesha WI 53188-5071
Phone: (262) 928-2396
Fax: (262) 544-1213
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1943 Wisconsin

Profile Details

NPI number 1700941234
LBN Legal business name Matejcek, Mary Jean
Credentials CADC II
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700941234 NPPES
Wisconsin MEDICAID 39387000

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