Individual
JORGE MARQUEZ DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 GATEWAY CT, WEST BEND, WI 53095-8539
(262) 335-8600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
47555
WI
2084N0400X
Neurology Physician
48487
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184671869
—
WI
Enumeration date
05/28/2006
Last updated
08/29/2024
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