MEDICARE: SEASONS HOSPICE & PALLIATIVE CARE OF WISCONSIN, LLC

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	251G00000X	Community Based Hospice Care Agency	2008	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407853112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEASONS HOSPICE & PALLIATIVE CARE OF WISCONSIN, LLC

Provider Business Mailing Address
First Line	:	6400 SHAFER CT STE 300A
Second Line	:
City	:	ROSEMONT
State	:	IL
Zip	:	60018-4914
Country	:	US
Telephone Number	:	847-759-9449
Fax Number	:	847-375-2148

Provider Business Practice Location Address
First Line	:	6737 W WASHINGTON ST STE 2150
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53214-5649
Country	:	US
Telephone Number	:	414-203-8310
Fax Number	:	414-203-8311

Authorized Official
Title or Position	:	VP LEGAL
Name	:	HEATHER SISCEL
Credential	:
Telephone Number	:	414-203-8310

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	12/02/2025

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