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General NPI Number Information
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NPI Number | 1407343965
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Entity Type | Organization
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Legal Business Name | INFORME HEALTHCARE LLC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 2741 W LAYTON AVE. SUITE 106
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City | MILWAUKEE
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State | WI
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Zip | 53221
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Country | US
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Telephone | 414-242-5468
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Fax |
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Provider Business Mailing Address
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Address Line | 2741 W LAYTON AVE. SUITE 106
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City | MILWAUKEE
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State | WI
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Zip | 53221
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Country | US
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Telephone | 414-242-5468
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JODI M CZERNEJEWSKI
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Credential |
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Telephone | 414-312-5165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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