Healthcare Provider Details

I. General information

NPI: 1033022579
Provider Name (Legal Business Name): ADRIANNAH D CHILLIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 W NATIONAL AVE
MILWAUKEE WI
53204-1347
US

IV. Provider business mailing address

3910 MINERAL POINT RD
MADISON WI
53705-5124
US

V. Phone/Fax

Practice location:
  • Phone: 920-393-8320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: