Healthcare Provider Details
I. General information
NPI: 1861896029
Provider Name (Legal Business Name): CHILDREN'S HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2014
Last Update Date: 05/21/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7201 W. GOOD HOPE RD. SUITE 200
MILWAUKEE WI
53223-4612
US
IV. Provider business mailing address
9000 W WISCONSIN AVE MAIL STATION 958
MILWAUKEE WI
53226-4874
US
V. Phone/Fax
- Phone: 414-337-8988
- Fax: 414-337-7042
- Phone: 414-266-7615
- Fax: 414-266-6238
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARC
CADIEUX
Title or Position: TREASURER/CHIEF FINANCIAL OFFICER
Credential:
Phone: 414-266-6401