Individual
DR. JILL C COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, FROEDTERT & MED COLLEGE CLIN - EAST, MILWAUKEE, WI 53226-3522
(414) 805-3666
Mailing address
9200 W WISCONSIN AVE, FROEDTERT & MED COLLEGE CLIN - EAST, MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
42531
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34556500
—
WI
Enumeration date
05/13/2006
Last updated
07/08/2007
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