Individual
NUSRAT KALLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9204
(262) 329-1000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
5005
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972557973
—
WI
05
—
34783800
—
WI
Enumeration date
05/22/2006
Last updated
10/04/2023
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