Healthcare Provider Details

I. General information

NPI: 1528734902
Provider Name (Legal Business Name): TMS CLINICAL SERVICES OF WISCONSIN SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 S 102ND ST STE 180
WEST ALLIS WI
53227-2466
US

IV. Provider business mailing address

1100 JORIE BLVD STE 300
OAK BROOK IL
60523-2219
US

V. Phone/Fax

Practice location:
  • Phone: 630-974-6602
  • Fax: 630-487-2411
Mailing address:
  • Phone: 630-974-6602
  • Fax: 630-487-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TERESA POPRAWSKI
Title or Position: PRESIDENT
Credential: MD
Phone: 630-974-6602