Healthcare Provider Details

I. General information

NPI: 1497728448
Provider Name (Legal Business Name): LORREE L DYOCO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DELAFIELD ST STE 120
WAUKESHA WI
53188-3402
US

IV. Provider business mailing address

1111 DELAFIELD ST STE 120
WAUKESHA WI
53188-3402
US

V. Phone/Fax

Practice location:
  • Phone: 262-544-4411
  • Fax: 262-650-3856
Mailing address:
  • Phone: 262-544-4411
  • Fax: 262-650-3856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number40448020
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number40448-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: