Individual
SUSAN J PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.- C
Contact information
Practice address
1244 WISCONSIN AVE, RACINE, WI 53403-1987
(262) 687-2273
(262) 687-2014
Mailing address
400 W RIVER WOODS PKWY, 3RD FLOOR, GLENDALE, WI 53212-1060
(414) 465-3091
(414) 465-4842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2295023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679720312
—
WI
Enumeration date
08/25/2008
Last updated
09/14/2015
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