Individual
DR. ALICIA MARIE CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
925 N 87TH ST, MILWAUKEE, WI 53226-4812
Mailing address
925 N 87TH ST, MILWAUKEE, WI 53226-4812
(414) 266-2020
(414) 266-2027
Taxonomy
Speciality
Code
Description
License number
State
152WP0200X
Pediatric Optometrist
Primary
3483-35
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831541887
—
MO
05
—
1831541887
—
WI
Enumeration date
07/01/2016
Last updated
03/11/2024
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