Provider Demographics
NPI:1932236726
Name:STUDENT HEALTH SERVICE
Entity Type:Organization
Organization Name:STUDENT HEALTH SERVICE
Other - Org Name:MARQUETTE UNIVERSITY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:414-288-5745
Mailing Address - Street 1:545 N 15TH ST
Mailing Address - Street 2:MARQUETTE UNIVERSITY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-1881
Mailing Address - Country:US
Mailing Address - Phone:414-288-7184
Mailing Address - Fax:414-288-5732
Practice Address - Street 1:545 N 15TH ST
Practice Address - Street 2:MARQUETTE UNIVERSITY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53201-1881
Practice Address - Country:US
Practice Address - Phone:414-288-7184
Practice Address - Fax:414-288-5732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health