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General NPI Number Information
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NPI Number | 1447437819
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Entity Type | Organization
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Legal Business Name | WOMENS WELLNESS
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 9916 75TH ST SUITE 200
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City | KENOSHA
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State | WI
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Zip | 53142-7583
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Country | US
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Telephone | 262-697-7750
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Fax | 262-697-7759
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Provider Business Mailing Address
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Address Line | 9916 75TH ST SUITE 200
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City | KENOSHA
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State | WI
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Zip | 53142-7583
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Country | US
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Telephone | 262-697-7750
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Fax | 262-697-7759
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY ZELKO
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Credential | D.O.
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Telephone | 262-697-7750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 24876-021
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License Number State | WI
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