Costello, Jill C
Costello, Jill C is an individual health care provider with primary practice located at 9200 W Wisconsin Ave Froedtert & Med College Clin - East, Milwaukee WI 53226-3522. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Costello, Jill C can be contacted via phone (414) 805-3666.Contact Information
Primary practice address
9200 W Wisconsin Ave Froedtert & Med College Clin - East
Milwaukee WI 53226-3522
Phone: (414) 805-3666
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 42531 | Wisconsin |
Profile Details
| NPI number | 1740231802 |
|---|---|
| LBN Legal business name | Costello, Jill C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1740231802 | NPPES |
| Wisconsin | MEDICAID | 34556500 |
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