Healthcare Provider Details
I. General information
NPI: 1174604599
Provider Name (Legal Business Name): WHEATON FRANCISCAN MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7400 W RAWSON AVE STE. G30
FRANKLIN WI
53132-8278
US
IV. Provider business mailing address
7400 W RAWSON AVE STE. G30
FRANKLIN WI
53132-8278
US
V. Phone/Fax
- Phone: 414-425-7000
- Fax: 414-425-7855
- Phone: 414-425-7000
- Fax: 414-425-7855
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LARRY
WADE
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 414-465-3000