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NPI Code Detail

MEDICARE: WHEATON FRANCISCAN MEDICAL GROUP

MEDICARE: WHEATON FRANCISCAN MEDICAL GROUP
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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11013860016OTHERWIDME

General Provider Information

NPI Number : 1871674408
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHEATON FRANCISCAN MEDICAL GROUP
Provider Business Mailing Address
First Line : 7961 N 76TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53223-3947
Country : US
Telephone Number : 414-462-7500
Fax Number : 414-462-3037
Provider Business Practice Location Address
First Line : 7961 N 76TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53223-3947
Country : US
Telephone Number : 414-462-7500
Fax Number : 414-462-3037
Authorized Official
Title or Position : DIRECTOR OF FINANCE
Name : LARRY WADE
Credential :
Telephone Number : 414-465-3000
Provider Enumeration Date : 10/18/2006
Last Update Date : 08/22/2020

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Directions to “WHEATON FRANCISCAN MEDICAL GROUP ” Practice Location

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