Provider Demographics
NPI:1174509012
Name:RADTKE, HEATHER B (MS, CGC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:B
Last Name:RADTKE
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF WISCONSIN, GENETICS, MS716
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226
Mailing Address - Country:US
Mailing Address - Phone:414-266-2905
Mailing Address - Fax:414-266-1616
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:CHILDREN'S HOSPITAL OF WISCONSIN, GENETICS, MS716
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-266-2905
Practice Address - Fax:414-266-1616
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS