MEDICARE: MRS. OSCAR C WILLE M.D.

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	51576	WI

General Provider Information

NPI Number	:	1376738336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. OSCAR C WILLE M.D.

Provider Business Mailing Address
First Line	:	4491 N OAKLAND AVE
Second Line	:
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-1611
Country	:	US
Telephone Number	:	414-999-3815
Fax Number	:

Provider Business Practice Location Address
First Line	:	4491 N OAKLAND AVE
Second Line	:
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-1611
Country	:	US
Telephone Number	:	414-999-3815
Fax Number	:

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

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	11/27/2024

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