Provider Demographics
NPI:1063049138
Name:OKON, NATALIA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:OKON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 WATERTOWN PLANK RD FL 5
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3548
Mailing Address - Country:US
Mailing Address - Phone:414-955-6778
Mailing Address - Fax:
Practice Address - Street 1:3916 S PROVIDENCE RD STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-7152
Practice Address - Country:US
Practice Address - Phone:573-882-1662
Practice Address - Fax:573-882-4096
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI85164-20207RC0000X
MO2024013935208000000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208000000XAllopathic & Osteopathic PhysiciansPediatrics