Individual
JILL A STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2906 S 20TH ST, MILWAUKEE, WI 53215-3732
(414) 385-8800
Mailing address
2815 CAMDEN LN, BROOKFIELD, WI 53045-3013
(262) 784-0544
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34173-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31944200
—
WI
Enumeration date
05/10/2006
Last updated
07/25/2008
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