=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982346300
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARY KATHRYN HILLS DO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2022
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 611 1ST AVE
-----------------------------------------------------
City | CHIPPEWA FALLS
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54729-1242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-838-5222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 860912
-----------------------------------------------------
City | MINNEAPOLIS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55486-0912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-838-5222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 81294-21
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------