MEDICARE: DR. QUEENETH N EGWU DNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209021726	IL

General Provider Information

NPI Number	:	1194338160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUEENETH N EGWU DNP

Provider Business Mailing Address
First Line	:	3030 NICKLAUS LN
Second Line	:
City	:	WADSWORTH
State	:	IL
Zip	:	60083-8944
Country	:	US
Telephone Number	:	847-693-1625
Fax Number	:

Provider Business Practice Location Address
First Line	:	3522 W LISBON AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-1953
Country	:	US
Telephone Number	:	414-935-8000
Fax Number	:	414-344-3396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	02/04/2026

Similar Medicare Providers

1245221977 — DR. RANDY R CIEPLUCH DDS
Practice Location Address:

3500 W LISBON AVE
MILWAUKEE, WI
53208-1953

Practice Phone: 414-342-0378
Practice Fax: 414-342-1008

1720153653 — PROGRESSIVE COMMUNITY HEALTH CENTERS, INC.
Practice Location Address:

3522 W LISBON AVE
MILWAUKEE, WI
53208-1953

Practice Phone: 414-935-8000
Practice Fax: 414-344-3396

1043483357 — RANDY R CIEPLUCH
Practice Location Address:

3500 W LISBON AVE
MILWAUKEE, WI
53208-1953

Practice Phone: 414-342-0378
Practice Fax: 414-342-1008

1245490127 — WESTSIDE HEALTHCARE ASSOCIATION INC
Practice Location Address:

3522 W LISBON AVE
MILWAUKEE, WI
53208-1953

Practice Phone: 414-935-8000
Practice Fax: 414-755-0058

1508129545 — RAMNEET BHATHAL M.D.
Practice Location Address:

3522 W LISBON AVE
MILWAUKEE, WI
53208-1953

Practice Phone: 414-935-8000
Practice Fax: 414-344-3396

1003163460 — RABANY CLAYBORN NP-C
Practice Location Address:

3522 W LISBON AVE
MILWAUKEE, WI
53208-1953

Practice Phone: 414-935-8000
Practice Fax:

Directions to “ DR. QUEENETH N EGWU DNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.