Individual
MRS. REBECCA S SEVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6000
(414) 649-5296
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
40372
TN
207R00000X
Internal Medicine Physician
Primary
45223
WI
208000000X
Pediatrics Physician
MD40372
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100016818
—
WI
05
—
3283015
—
TN
05
—
33364651
—
TN
05
—
3336466
—
TN
05
—
3732438
—
TN
01
—
4116218
BCBS
TN
01
—
4152683
BCBST
—
Enumeration date
12/19/2005
Last updated
11/05/2024
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