MEDICARE: DR. RACHEL A TESKE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	38114	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114921962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL A TESKE MD

Provider Business Mailing Address
First Line	:	500 E VETERANS ST
Second Line	:
City	:	TOMAH
State	:	WI
Zip	:	54660-3105
Country	:	US
Telephone Number	:	608-372-3971
Fax Number	:	608-372-1249

Provider Business Practice Location Address
First Line	:	500 E VETERANS ST
Second Line	:
City	:	TOMAH
State	:	WI
Zip	:	54660-3105
Country	:	US
Telephone Number	:	608-372-3971
Fax Number	:	608-372-1249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	12/05/2014

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