MEDICARE: CATHERINE OKORO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1225402910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE OKORO

Provider Business Mailing Address
First Line	:	4619 N 48TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-5120
Country	:	US
Telephone Number	:	414-736-5943
Fax Number	:

Provider Business Practice Location Address
First Line	:	4619 N 48TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-5120
Country	:	US
Telephone Number	:	414-736-5943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2015
Last Update Date	:	11/19/2015

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Directions to “ CATHERINE OKORO ” Practice Location

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