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NPI Code Detail

MEDICARE: DR. MICHAEL A PORTE MD

MEDICARE: DR. MICHAEL A PORTE 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
12080N0001XNeonatal-Perinatal Medicine Physician036065716IL
22080N0001XNeonatal-Perinatal Medicine Physician27762WI

General Provider Information

NPI Number : 1336141530
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL A PORTE MD
Provider Business Mailing Address
First Line : 5510 TREMPEALEAU TRL
Second Line :
City : MADISON
State : WI
Zip : 53705-4648
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1740 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-7232
Country : US
Telephone Number : 312-492-2706
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 04/17/2025

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