Individual
CHAD GLISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 329-5950
(414) 329-5943
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
66427
WI
207RH0003X
Hematology & Oncology Physician
Primary
66427
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100061678
—
WI
05
—
1134514078
—
WI
Enumeration date
03/30/2015
Last updated
10/20/2023
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