Provider Demographics
NPI:1447572805
Name:LIJEWSKI, MARGARET RAE (DC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:RAE
Last Name:LIJEWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:RAE
Other - Last Name:HERRIGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:524 S MAIN ST
Mailing Address - Street 2:STE 102
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-3936
Mailing Address - Country:US
Mailing Address - Phone:262-353-3733
Mailing Address - Fax:
Practice Address - Street 1:524 S MAIN ST
Practice Address - Street 2:STE 102
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-3936
Practice Address - Country:US
Practice Address - Phone:262-353-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4591-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor