Individual
ELLEN HALLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1121 E NORTH AVE, MILWAUKEE, WI 53212-3515
(414) 267-6502
(414) 267-3892
Mailing address
1121 E NORTH AVE, MILWAUKEE, WI 53212-3515
(414) 267-6502
(414) 267-3892
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
76267
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942838941
—
WI
Enumeration date
03/27/2020
Last updated
05/19/2023
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