Individual
JILAINE M. BOLEK BERQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6855
Mailing address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48867
WI
207RR0500X
Rheumatology Physician
Primary
48867-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346208766
—
WI
Enumeration date
05/03/2006
Last updated
11/29/2021
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