Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Brian Tillis, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1396107405

Dr. Brian Tillis, MD is an Obstetrics/Gynecology in Pleasant Prairie, Wisconsin. Graduated from Southern Illinois University School of Medicine in 2016, 10 years ago. Practices with Froedtert South Inc, a 156-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
10
Trained at
Southern Illinois University School of Medicine
Licensed in
WI
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9555 76th St Ste 4105
Pleasant Prairie, WI 53158-1984
Phone: (262) 577-8080
Fax: (262) 577-8081
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 69543-20 (WI)

Record details

NPI number1396107405
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 28, 2016
Last updated in NPPESJuly 16, 2020
Certification dateJuly 16, 2020
Mailing address9555 76th St # 4105, Pleasant Prairie, WI 53158-1984

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Froedtert South Inc — 156 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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