MEDICARE: MICHAEL CHRISTENSEN M.D.

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	207R00000X	Internal Medicine Physician	036084833	IL
2	207R00000X	Internal Medicine Physician	56845	WI
3	208M00000X	Hospitalist Physician	56845	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	011546	OTHER	IL	HEALTH ALLIANCE MEDICAL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	9815737	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1588754667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CHRISTENSEN M.D.

Provider Business Mailing Address
First Line	:	1550 E ROYALL PL
Second Line	:	#601
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-1869
Country	:	US
Telephone Number	:	414-328-7146
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 E ROYALL PL
Second Line	:	#601
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-1869
Country	:	US
Telephone Number	:	414-328-7146
Fax Number	:

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	10/31/2023

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