Healthcare Provider Details

I. General information

NPI: 1265447098
Provider Name (Legal Business Name): WHEATON FRANCISCAN HEALTHCARE-ALL SAINTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 WARWICK WAY
RACINE WI
53406-5661
US

IV. Provider business mailing address

1139 WARWICK WAY
RACINE WI
53406-5661
US

V. Phone/Fax

Practice location:
  • Phone: 262-687-7550
  • Fax:
Mailing address:
  • Phone: 262-687-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateWI

VIII. Authorized Official

Name: MS. SUSAN BOLAND
Title or Position: PRESIDENT/CEO
Credential:
Phone: 262-687-4886