Healthcare Provider Details

I. General information

NPI: 1265316103
Provider Name (Legal Business Name): JOSE ARTURO GONZALEZ-VILLARREAL DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 S CESAR E CHAVEZ DR
MILWAUKEE WI
53204-2203
US

IV. Provider business mailing address

PO BOX 778789
CHICAGO IL
60677-8789
US

V. Phone/Fax

Practice location:
  • Phone: 414-672-1353
  • Fax: 262-408-5094
Mailing address:
  • Phone: 414-672-1353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1795333
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number24613930
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: