Provider Demographics
NPI:1033685359
Name:CORCHADO, DELIA IVETTE
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:IVETTE
Last Name:CORCHADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4135 W VLIET ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-2766
Mailing Address - Country:US
Mailing Address - Phone:414-704-6790
Mailing Address - Fax:
Practice Address - Street 1:6737 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-5647
Practice Address - Country:US
Practice Address - Phone:414-246-2357
Practice Address - Fax:414-246-2524
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator