Healthcare Provider Details

I. General information

NPI: 1700309234
Provider Name (Legal Business Name): ELLEN LOUISE OLEK FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLEN LOUISE HEMMER

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 2ND STREET THEDA CLARK MEDICAL PLAZA
NEENAH WI
54956-2883
US

IV. Provider business mailing address

604 32ND ST
ROCK ISLAND IL
61201-2029
US

V. Phone/Fax

Practice location:
  • Phone: 920-831-5050
  • Fax: 920-729-2104
Mailing address:
  • Phone: 630-217-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN270559
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9062
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209019307
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: