Individual
DR. JUSTIN EDWARD WITTKOPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 N MILWAUKEE AVE UNIT 200, VERNON HILLS, IL 60061-1637
(414) 771-6780
(414) 238-2424
Mailing address
10001 W INNOVATION DR STE 200, WAUWATOSA, WI 53226-4851
(414) 771-6780
(414) 238-2424
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036-123362
IL
207YX0901X
Otology & Neurotology Physician
036123362
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275521288
—
WI
Enumeration date
09/29/2008
Last updated
07/20/2023
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