Healthcare Provider Details

I. General information

NPI: 1235163494
Provider Name (Legal Business Name): SAUK PRAIRIE HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HELEN ST
SAUK CITY WI
53583-1101
US

IV. Provider business mailing address

260 26TH STREET
PRAIRIE DU SAC WI
53578-2203
US

V. Phone/Fax

Practice location:
  • Phone: 608-643-3351
  • Fax: 608-643-3621
Mailing address:
  • Phone: 608-643-3311
  • Fax: 608-643-3621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES A DREGNEY
Title or Position: VICE PRESIDENT FINANCE & OPERATIONS
Credential:
Phone: 608-643-3311