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General NPI Number Information
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NPI Number | 1497187181
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Entity Type | Individual
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Provider Name | SARAH J WILCZEK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2013
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Last Update Date | 08/05/2013
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Provider Practice Location Address
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Address Line | 699 S GREEN BAY RD
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City | NEENAH
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State | WI
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Zip | 54956-3153
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Country | US
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Telephone | 920-751-0270
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Fax | 920-751-0267
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Provider Business Mailing Address
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Address Line | 699 S GREEN BAY RD
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City | NEENAH
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State | WI
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Zip | 54956-3153
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Country | US
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Telephone | 920-751-0270
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Fax | 920-751-0267
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 14201-040
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License Number State | WI
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