Ian Vanantwerp, DO

Radiology, Diagnostic Radiology in Milwaukee, WI. Individual provider (NPI-1).

NPI number1962080689

StatusActive

Last updated in NPPESAug 3, 2026

Details

NPI: 1962080689
Entity type: Individual (NPI-1)
Name: Ian Vanantwerp
Credential: DO
Sex: Male
Sole proprietor: No
Enumeration date: Apr 1, 2021
Certification date: Aug 3, 2026
Last updated: Aug 3, 2026

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Part B No · DME Yes · Home health No · Power mobility Yes · Hospice No
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2085R0202X	Radiology, Diagnostic Radiology	125078762	IL	Yes
2085N0700X		82153-21	WI

Practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Phone 414-955-1182

Mailing address

9200 W Wisconsin Ave
Wauwatosa, WI 53226-3522

Phone 414-955-1182

Is something wrong?

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Other Diagnostic Radiology Physician providers in Milwaukee, WI

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