Physician Compare National (NPI:1023070364)

HEALTHCARE PROVIDER: LOUIE COULIS M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1023070364
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901707371
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100322000894
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COULIS
	Individual professional last name
Provider First Name	LOUIE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA MEDICAL COLLEGE, SCHOOL OF MEDICINE OF PURDUE UNIVERSITY
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LOUIE COULIS MD SC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0749180529
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1414 N TAYLOR DR
	Group Practice or individual's line 1 address
City	SHEBOYGAN
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	530813044
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9204589800
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	520044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST NICHOLAS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y