MEDICARE: JESSICA SUSAN LELINSKI 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	57036-20	WI
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	57593	MN
3	207ZF0201X	Forensic Pathology Physician	57036-20	WI

General Provider Information

NPI Number	:	1770808305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SUSAN LELINSKI M.D.

Provider Business Mailing Address
First Line	:	933 W HIGHLAND AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-1445
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	933 W HIGHLAND AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-1445
Country	:	US
Telephone Number	:	414-223-1200
Fax Number	:

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

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	04/10/2020

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