Individual
KAITLIN A PHILIPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
7878 N 76TH ST, MILWAUKEE, WI 53223-3914
(414) 586-5710
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0003579
CO
152W00000X
Optometrist
Primary
3686
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100177909
—
WI
Enumeration date
05/18/2020
Last updated
08/15/2024
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