Individual
MRS. JESSICA MARIE MCILRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3111 GUNDERSEN DR, ONALASKA, WI 54650-8447
(608) 782-7300
Mailing address
3111 GUNDERSEN DR, ONALASKA, WI 54650-8447
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
1761
WI
2084N0400X
Neurology Physician
DO-04367
IA
2084P0800X
Psychiatry Physician
Primary
1761
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447577424
—
IA
01
—
P01364307
RR MEDICARE
IA
Enumeration date
04/29/2010
Last updated
12/05/2022
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