Individual
MRS. DARA J MICKSCHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3540 S 43RD ST, MILWAUKEE, WI 53220-1502
(872) 231-3162
Mailing address
PO BOX 74008272, CHICAGO, IL 60674-8272
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2410
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073741641
—
WI
Enumeration date
06/23/2009
Last updated
10/03/2025
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