MEDICARE: MR. MATTHEW J. ORZEL PA

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	363AM0700X	Medical Physician Assistant	085002635	IL
2	363A00000X	Physician Assistant	4751-23	WI

General Provider Information

NPI Number	:	1639215197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW J. ORZEL PA

Provider Business Mailing Address
First Line	:	10001 W INNOVATION DR STE 200
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-4851
Country	:	US
Telephone Number	:	414-771-6780
Fax Number	:	414-238-2424

Provider Business Practice Location Address
First Line	:	8500 75TH STREET
Second Line	:	SUITE 101
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-2049
Country	:	US
Telephone Number	:	414-771-6760
Fax Number	:	414-238-2424

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	05/05/2021

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