Provider Demographics
NPI:1033646971
Name:QUINN, MILA VIOLA (MD)
Entity Type:Individual
Prefix:
First Name:MILA
Middle Name:VIOLA
Last Name:QUINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 WILLIAMSON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3515
Mailing Address - Country:US
Mailing Address - Phone:608-877-7727
Mailing Address - Fax:608-258-6933
Practice Address - Street 1:613 WILLIAMSON ST STE 205
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3515
Practice Address - Country:US
Practice Address - Phone:608-877-7727
Practice Address - Fax:608-258-6933
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0706062085R0202X
IL125070606207R00000X
WI771602085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine