Provider Demographics
NPI:1891158648
Name:BRISCOE, JOYCE K (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:K
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-2060
Mailing Address - Fax:414-259-9290
Practice Address - Street 1:825 W STATE ST STE 103E
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2078
Practice Address - Country:US
Practice Address - Phone:630-208-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI770482085R0202X
IL036.1657422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.165742OtherSTATE LICENSE