Individual
LYLE ANTHONY IGNACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
930 W HISTORIC MITCHELL ST, MILWAUKEE, WI 53204-3533
(414) 383-9526
(414) 389-3881
Mailing address
930 W HISTORIC MITCHELL ST, MILWAUKEE, WI 53204-3533
(414) 383-9526
(414) 389-3881
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39069-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Z9506
—
NM
05
—
1649209545
—
WI
05
—
474362
—
AZ
01
—
K400126747
MEDICARE PTAN
WI
Enumeration date
07/02/2006
Last updated
05/22/2025
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