Provider Demographics
NPI:1568524643
Name:ZILSKE, JEANNE S (MS, ATRL-BC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:S
Last Name:ZILSKE
Suffix:
Gender:F
Credentials:MS, ATRL-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 WYNFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-3352
Mailing Address - Country:US
Mailing Address - Phone:262-227-8959
Mailing Address - Fax:
Practice Address - Street 1:12630 W NORTH AVE
Practice Address - Street 2:EASTBROOK OFFICE PARK
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4626
Practice Address - Country:US
Practice Address - Phone:262-227-8959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48-036221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI01-129OtherDRL