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General NPI Number Information
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NPI Number | 1871674408
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Entity Type | Organization
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Legal Business Name | WHEATON FRANCISCAN MEDICAL GROUP
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7961 N 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53223-3947
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Country | US
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Telephone | 414-462-7500
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Fax | 414-462-3037
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Provider Business Mailing Address
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Address Line | 7961 N 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53223-3947
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Country | US
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Telephone | 414-462-7500
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Fax | 414-462-3037
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | LARRY WADE
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Credential |
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Telephone | 414-465-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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