Provider Demographics
NPI:1598759599
Name:REESE, YOLANDA C (MD)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:C
Last Name:REESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:C
Other - Last Name:RAINGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:MS 8000
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-7615
Mailing Address - Fax:414-266-3803
Practice Address - Street 1:7720 W. GOOD HOPE RD.
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223
Practice Address - Country:US
Practice Address - Phone:414-536-0236
Practice Address - Fax:414-536-0260
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39595208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32565600Medicaid
WIG95678Medicare UPIN
WI32565600Medicaid