Individual
JOLENE E. ANDRYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12203 CORPORATE PKWY, MEQUON, WI 53092-3388
(262) 387-8200
(262) 387-8271
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
37943
WI
208200000X
Plastic Surgery Physician
Primary
37943
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33345200
—
WI
01
—
P00679656
RR MEDICARE
WI
Enumeration date
06/24/2006
Last updated
11/19/2021
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