Physician Compare National (NPI:1801091269)

HEALTHCARE PROVIDER: MICHELLE MARIE HAUCK 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	1801091269
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840322871
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100709000460
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAUCK
	Individual professional last name
Provider First Name	MICHELLE
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	GUNDERSEN LUTHERAN MEDICAL CENTER INC
	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	2163331414
	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	602
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1836 S AVE
	Group Practice or individual's line 1 address
City	LA CROSSE
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	546015429
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6087837300
	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	150082
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DEACONESS HOSPITAL INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	520087
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GUNDERSEN LUTHERAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	240044
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WINONA HEALTH SERVICES
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	521309
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MOUNDVIEW MEMORIAL HOSPITAL AND CLINICS
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y