Acevedo, Ismael
Acevedo, Ismael is an individual health care provider with primary practice located at 4555 W Schroeder Dr 185, Brown Deer WI 53223-1475. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Acevedo, Ismael can be contacted via phone (414) 586-0222.Contact Information
Primary practice address
4555 W Schroeder Dr 185
Brown Deer WI 53223-1475
Phone: (414) 586-0222
Fax: (414) 586-0236
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1687-132 | Wisconsin |
Profile Details
| NPI number | 1669654125 |
|---|---|
| LBN Legal business name | Acevedo, Ismael |
| Credentials | CSAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 27th, 2007 |
| Last updated | Nov 27th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669654125 | NPPES |
| Wisconsin | MEDICAID | 39357400 |
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