MEDICARE: PLANNED PARENTHOOD OF WISCONSIN

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	332900000X	Non-Pharmacy Dispensing Site
2	261QA0005X	Ambulatory Family Planning Facility

General Provider Information

NPI Number	:	1295909836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD OF WISCONSIN

Provider Business Mailing Address
First Line	:	302 N JACKSON ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-5904
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	834 MAIN ST
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53403-1523
Country	:	US
Telephone Number	:	262-634-2060
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, BUS OPERS.
Name	:	SUSAN MARIE ODEGAARD
Credential	:
Telephone Number	:	414-289-3796

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	04/10/2026

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Directions to “PLANNED PARENTHOOD OF WISCONSIN ” Practice Location

Language	Start Address	Practice Location

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