Provider Demographics
NPI:1811347958
Name:UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Entity type:Organization
Organization Name:UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR & CLINICAL ASSOC PROFESSOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A, FAAA
Authorized Official - Phone:414-607-1830
Mailing Address - Street 1:10425 W NORTH AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-2416
Mailing Address - Country:US
Mailing Address - Phone:414-607-1830
Mailing Address - Fax:414-607-0127
Practice Address - Street 1:10425 W NORTH AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-2416
Practice Address - Country:US
Practice Address - Phone:414-607-1830
Practice Address - Fax:414-607-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty