Provider Demographics
NPI:1023056439
Name:NEUROLOGY CENTER OF MILWAUKEE, LLC
Entity type:Organization
Organization Name:NEUROLOGY CENTER OF MILWAUKEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RASSOULI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-342-6300
Mailing Address - Street 1:3201 S 16TH ST
Mailing Address - Street 2:SUITE 1019
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4537
Mailing Address - Country:US
Mailing Address - Phone:414-342-6300
Mailing Address - Fax:414-342-5501
Practice Address - Street 1:3201 S 16TH ST
Practice Address - Street 2:SUITE 1019
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4537
Practice Address - Country:US
Practice Address - Phone:414-342-6300
Practice Address - Fax:414-342-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty