Provider Demographics
NPI:1780677484
Name:KALTER, RACHEL E (DO)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:E
Last Name:KALTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 W OKLAHOMA AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4455
Mailing Address - Country:US
Mailing Address - Phone:414-672-5250
Mailing Address - Fax:414-672-2290
Practice Address - Street 1:770 INDIAN BOUNDARY RD STE 200
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-1519
Practice Address - Country:US
Practice Address - Phone:219-872-6566
Practice Address - Fax:219-395-8077
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40064207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI001302475Medicare ID - Type Unspecified
WIE60483Medicare UPIN