MEDICARE: MILWAUKEE ORTHOPEDIC SPECIALISTS, S.C.

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	174400000X	Specialist

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	:	1407820244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILWAUKEE ORTHOPEDIC SPECIALISTS, S.C.

Provider Business Mailing Address
First Line	:	1575 N RIVERCENTER DR
Second Line	:	SUITE 160
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-3978
Country	:	US
Telephone Number	:	414-274-7220
Fax Number	:	414-274-7227

Provider Business Practice Location Address
First Line	:	1575 N RIVERCENTER DR
Second Line	:	SUITE 160
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-3978
Country	:	US
Telephone Number	:	414-274-7220
Fax Number	:	414-274-7227

Authorized Official
Title or Position	:	CLINIC ADMINISTRATOR
Name	:	MS. RACHAEL POLZIN
Credential	:
Telephone Number	:	414-274-7220

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	08/22/2020

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