Basic Information
Provider Information
NPI: 1730290214
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: TERESA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7974 UW HEALTH CT
Address2:  
City: MIDDLETON
State: WI
PostalCode: 535625531
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 600 HIGHLAND AVE
Address2:  
City: MADISON
State: WI
PostalCode: 537923901
CountryCode: US
TelephoneNumber: 6082639729
FaxNumber: 6082630682
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 10/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085P0229X77366-20WIY Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
2085P0229XMD00046911WAN Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology

No ID Information.


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