| Creekside Chiropractic | |
|
4000 Enterprise Dr, Sheboygan, WI 53083-2245 | |
| (920) 459-9090 | |
| (920) 459-7426 |
| Full Name | Creekside Chiropractic |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 4000 Enterprise Dr, Sheboygan, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801076872 | NPI | - | NPPES |
| 38834800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 2308-12 (Wisconsin) | Secondary |
| 111N00000X | Chiropractor | 4058-012 (Wisconsin) | Secondary |
| 111N00000X | Chiropractor | 4549-12 (Wisconsin) | Primary |
| Provider Name | Russell N Petersen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1164550620 PECOS PAC ID: 5698796449 Enrollment ID: I20051208000626 |
| Provider Name | Andrew Lee Tislau |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1538499827 PECOS PAC ID: 9032393434 Enrollment ID: I20110408000567 |
| Provider Name | Jacob William Kornetzke |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1386170793 PECOS PAC ID: 2365729605 Enrollment ID: I20170515001538 |
| Provider Name | Michael Alexander Budjak |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689384802 PECOS PAC ID: 8224400973 Enrollment ID: I20230207001720 |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Chiropractic 4000 Enterprise Dr, Sheboygan, WI 53083-2245 Ph: (920) 459-9090 | Creekside Chiropractic 4000 Enterprise Dr, Sheboygan, WI 53083-2245 Ph: (920) 459-9090 |
Rachel E Smith, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 707 S Taylor Dr, Sheboygan, WI 53081 Phone: 920-451-7000 | |
Dr. Brian Giuliani, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-828-2530 Fax: 920-828-2535 | |
Dr. Timothy S Kroneck, D.C. Chiropractor Medicare: Medicare Enrolled Practice Location: 1720 N 8th St, Sheboygan, WI 53081 Phone: 920-803-2225 Fax: 920-803-3001 | |
Dr. Daniel Paul Grimm, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 909 S Taylor Dr, Sheboygan, WI 53081 Phone: 920-451-7000 Fax: 920-451-7100 | |
Dr. Russell N Petersen, D.C Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 4027 S Business Dr, Sheboygan, WI 53081 Phone: 920-459-9090 Fax: 920-459-7426 | |
Dr. Jodi B Rabas, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1320 N Taylor Dr, Sheboygan, WI 53081 Phone: 920-459-8475 Fax: 920-694-0437 | |
Colton Family Chiropractic, Llc Chiropractor Medicare: Medicare Enrolled Practice Location: 3411b Lakeshore Rd, Sheboygan, WI 53083 Phone: 920-458-8886 |