Individual
EDWARD ST VILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2000 E LAYTON AVE, ST FRANCIS, WI 53235-6053
(414) 744-6589
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36436
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32246200
—
WI
Enumeration date
07/25/2006
Last updated
09/09/2024
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