Healthcare Provider Details

I. General information

NPI: 1003234782
Provider Name (Legal Business Name): ALISON COREN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE
MILWAUKEE WI
53226-4874
US

IV. Provider business mailing address

999 N 92ND ST SUITE 430
MILWAUKEE WI
53226-4875
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-6750
  • Fax: 414-266-6749
Mailing address:
  • Phone: 414-266-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number64842
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: