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Individual

KATHERINE ANN HALLENBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2000 E LAYTON AVE, ST FRANCIS, WI 53235-6053
(414) 744-6589
(414) 747-8848
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
49611
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100015579
WI
05
200985740
IN
01
P00851234
RAILROAD MEDICARE
IN
Enumeration date
10/26/2007
Last updated
10/16/2023
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