Individual
JOANNE ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-5600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02003919A
IN
207P00000X
Emergency Medicine Physician
036129189
IL
207P00000X
Emergency Medicine Physician
Primary
74900
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096722
—
WI
Enumeration date
03/18/2009
Last updated
01/24/2024
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