Rodrigo Itable, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20287 Issued in WI

Practice address

2745 W Layton Ave
Suite 201
Milwaukee, WI 53221-2651

Phone

(414) 281-0050

Fax

(414) 281-0733

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003826892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 GLADSTONE LN",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531291511",
            "telephone_number": "414-529-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 W LAYTON AVE",
            "address_2": "SUITE 201",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212651",
            "telephone_number": "414-281-0050",
            "fax_number": "414-281-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITABLE",
        "first_name": "RODRIGO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "20287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zainul Ismail, PHARMD
• Mohameddeq A Isse
• Alexandra C Istl, MD MPH
• Jamie M Istwan, PT
• Fernando T. Itable, M.D.
• Doha Itani
• Vladimir Ivanovic, M.D.
• Karen Ann (a.) Ivantic, N.P.
• Andrew Jack Iverson, PHARMD
• Katherine Teresa Ringler Iverson

• Family Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.