Provider Demographics
NPI:1922030055
Name:KREILING, KAREN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:KREILING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17855 DALLAS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6857
Mailing Address - Country:US
Mailing Address - Phone:346-376-1702
Mailing Address - Fax:224-532-2780
Practice Address - Street 1:6737 W WASHINGTON ST STE 2150
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-5649
Practice Address - Country:US
Practice Address - Phone:414-203-8310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI81608208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
02223542Medicare UPIN