Provider Demographics
NPI:1336452861
Name:HALLETT, JOSHUA P (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:P
Last Name:HALLETT
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:111 E WISCONSIN AVE
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4815
Mailing Address - Country:US
Mailing Address - Phone:414-290-6720
Mailing Address - Fax:414-290-6755
Practice Address - Street 1:801 S MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3204
Practice Address - Country:US
Practice Address - Phone:414-290-6720
Practice Address - Fax:414-290-6755
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2021-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101018967207P00000X
IL036.136964207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine