Basic Information
Provider Information
NPI: 1164652947
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KILARI
FirstName: DEEPAK
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9200 W WISCONSIN AVE
Address2: NEOPLASTIC DISEASES
City: MILWAUKEE
State: WI
PostalCode: 532263522
CountryCode: US
TelephoneNumber: 4148056800
FaxNumber: 4148056805
Practice Location
Address1: 9200 W WISCONSIN AVE
Address2: NEOPLASTIC DISEASES
City: MILWAUKEE
State: WI
PostalCode: 532263522
CountryCode: US
TelephoneNumber: 4148056800
FaxNumber: 4148056805
Other Information
ProviderEnumerationDate: 07/15/2009
LastUpdateDate: 07/12/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X61043WIY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207R00000X253819NYN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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