Individual
DR. JILL M UNDERBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
5000 W NATIONAL AVE, PRIMARY CARE YELLOW CLINIC, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 389-4198
Mailing address
2358 N 62ND ST, WAUWATOSA, WI 53213-1510
(414) 258-1777
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12258-040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89455
VA#
WI
Enumeration date
07/16/2006
Last updated
07/08/2007
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