Provider Demographics
NPI:1871817734
Name:PHELAN, RACHEL ANN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:PHELAN
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC HEMATOLOGY AND ONCOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-955-4170
Mailing Address - Fax:414-955-6543
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC HEMATOLOGY AND ONCOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-955-4170
Practice Address - Fax:414-955-6543
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2023-01-09
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Provider Licenses
StateLicense IDTaxonomies
WI658722080P0204X, 2080P0207X
MN570422080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1871817734Medicaid
WI1871817734Medicaid