Provider Demographics
NPI:1174593487
Name:AGUILERA, HECTOR G (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:G
Last Name:AGUILERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E WISCONSIN AVE
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4815
Mailing Address - Country:US
Mailing Address - Phone:414-290-6720
Mailing Address - Fax:414-290-6755
Practice Address - Street 1:111 E WISCONSIN AVE
Practice Address - Street 2:SUITE 2000
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4815
Practice Address - Country:US
Practice Address - Phone:414-290-6720
Practice Address - Fax:414-290-6755
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39452207P00000X
IL036056821207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI930057377OtherMEDICARE RAILROAD
IL036056821Medicaid
WI32407300Medicaid
IL930062821OtherMEDICARE RAILROAD
WI930052746OtherMEDICARE RAILROAD
ILP00054855OtherMEDICARE RAILROAD
C42615Medicare UPIN
WI0046-68655Medicare ID - Type Unspecified
WI0007-45034Medicare ID - Type Unspecified
IL036056821Medicaid
ILP00054855OtherMEDICARE RAILROAD
WI0007-71116Medicare ID - Type Unspecified
ILL64090Medicare ID - Type Unspecified
WI930052746OtherMEDICARE RAILROAD
WI0047-01400Medicare ID - Type Unspecified