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NPI Code Detail

MEDICARE: WHEATON FRANCISCAN HEALTHCARE TERRACE AT ST. FRANCIS, INC.

MEDICARE: WHEATON FRANCISCAN HEALTHCARE TERRACE AT ST. FRANCIS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityWI
2314000000XSkilled Nursing Facility3129WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2391613624025OTHERWIBX/BS PROVIDER NUMBER

General Provider Information

NPI Number : 1659304335
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHEATON FRANCISCAN HEALTHCARE TERRACE AT ST. FRANCIS, INC.
Provider Business Mailing Address
First Line : 19525 W NORTH AVE
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-4107
Country : US
Telephone Number : 262-785-1114
Fax Number : 262-780-3805
Provider Business Practice Location Address
First Line : 19525 W NORTH AVE
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-4107
Country : US
Telephone Number : 262-785-1114
Fax Number : 262-780-3805
Authorized Official
Title or Position : CEO
Name : ERIN SHADBOLT
Credential :
Telephone Number : 314-729-3500
Provider Enumeration Date : 07/08/2006
Last Update Date : 02/04/2026

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