Individual provider · NPI-1

Dr. Karen Ronquillo, M.S., M.D.

Preventive Medicine, Occupational Medicine · Waukesha, WI

NPI number1467757948
StatusActive
Last updated in NPPESJul 21, 2022

Details

NPI
1467757948
Entity type
Individual (NPI-1)
Name
Dr. Karen Ronquillo
Credential
M.S., M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jan 14, 2011
Certification date
Jul 21, 2022
Last updated
Jul 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2083X0100X Preventive Medicine, Occupational Medicine55146-20WIYes
2083C0008X Preventive Medicine, Clinical Informatics Specialist55146-20WI
208D00000X General PracticeACN 378FL
208D00000X General Practice55146-020WI

Other names

  • Karen Dizon (Professional Name)

Practice location

20611 Watertown Rd Ste C
Waukesha, WI 53186-1871

Phone 262-333-3173 · Fax 262-333-3173

Mailing address

300 E Broadway
Waukesha, WI 53187-3001

Phone 414-708-8852 · Fax 262-364-3099

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