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Contact Information

TRACEY H LILJESTROM
9000 W WISCONSIN AVE
MILWAUKEE, WI53226-4874
 Phone: 414-337-7050
 Fax: 414-337-7020
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neonatal-Perinatal Medicine

2080N0001X 37 Physician/Pediatric Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for TRACEY H LILJESTROM · (Female)

NPI Number 1962768036
Status Active
Credentials
Entity Individual
Enumeration date 04/03/2012
Last updated 04/08/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 67663
  • WI Medicaid 1962768036
Hospital affiliation(s)
  • FROEDTERT MEMORIAL LUTHERAN HSPTL - (Acute Care)
    9200 W WISCONSIN AVE
    MILWAUKEE, WI 53226
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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