Individual
CHRISTOPHER R TAKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC PSYCHIATRY, MILWAUKEE, WI 53226-4874
(414) 607-5280
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC PSYCHIATRY, MILWAUKEE, WI 53226-4874
(414) 607-5280
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
55474
MN
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
65401
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013203652
—
WI
Enumeration date
06/22/2011
Last updated
03/23/2017
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