Healthcare Provider Details

I. General information

NPI: 1427081637
Provider Name (Legal Business Name): PATRICIA ANNE SCHICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA A MCDOUGALL-SCHICK MD

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 REDBIRD CIR
DE PERE WI
54115-7977
US

IV. Provider business mailing address

PO BOX 22487
GREEN BAY WI
54305-2487
US

V. Phone/Fax

Practice location:
  • Phone: 920-338-6820
  • Fax: 920-338-6829
Mailing address:
  • Phone: 920-445-7222
  • Fax: 920-445-7229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number4301500829
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number38977-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: