Healthcare Provider Details

I. General information

NPI: 1538295308
Provider Name (Legal Business Name): RACHEL PURDY HEILMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL PURDY M.D.

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 10/04/2023
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 N 51ST ST SUITE 309
MILWAUKEE WI
53210-1645
US

IV. Provider business mailing address

PO BOX 1327
BROOKFIELD WI
53008-1327
US

V. Phone/Fax

Practice location:
  • Phone: 414-447-2674
  • Fax: 414-447-1070
Mailing address:
  • Phone: 414-447-2674
  • Fax: 414-447-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number64006-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL-224776
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number64004-20
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number64006-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: