Provider Demographics
NPI:1013147883
Name:MACALLISTER, REBECCA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:MACALLISTER
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 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DEPT OF INTERNAL MEDICINE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6850
Mailing Address - Fax:414-805-6851
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-3522
Practice Address - Country:US
Practice Address - Phone:608-263-6400
Practice Address - Fax:608-833-0999
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI55832207R00000X
WI55832-20208M00000X
FLME116560207R00000X
MI4301105297207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009076200Medicaid
WI1013147883Medicaid
WI1013147883Medicaid