Alan J Licup, MD | |
12500 Aurora Dr, Pleasant Prairie, WI 53158 | |
(262) 854-5000 | |
Not Available |
Full Name | Alan J Licup |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 18 Years |
Location | 12500 Aurora Dr, Pleasant Prairie, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205048246 | NPI | - | NPPES |
100061195 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 036128087 (Illinois) | Secondary |
208600000X | Surgery | 66270-20 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Aurora Medical Group, Inc. | 6709794258 | 3269 |
Entity Name | Aurora Medical Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Mailing Address | Practice Location Address |
---|---|
Alan J Licup, MD 3301 W Forest Home Ave, Milwaukee, WI 53215-2843 Ph: (414) 389-2233 | Alan J Licup, MD 12500 Aurora Dr, Pleasant Prairie, WI 53158 Ph: (262) 854-5000 |
Dr. Markian J Kuzycz, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 12500 Aurora Dr, Pleasant Prairie, WI 53158 Phone: 262-854-5000 | |
Karl A Greene, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 9555 76th St, Pleasant Prairie, WI 53158 Phone: 262-577-8000 Fax: 262-577-8869 | |
Dr. David Needle, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 12500 Aurora Dr, Pleasant Prairie, WI 53158 Phone: 262-857-5000 | |
Majed Jandali, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 9555 76th St Ste 4880, Pleasant Prairie, WI 53158 Phone: 262-748-1001 Fax: 262-748-1020 | |
Brian Christopher Hill, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 9697 Saint Catherines Dr, Pleasant Prairie, WI 53158 Phone: 262-671-7530 Fax: 262-671-7535 |