Dr Brian Tillis, MD | |
9555 76th St Ste 4105, Pleasant Prairie, WI 53158-1984 | |
(262) 577-8080 | |
(262) 577-8081 |
Full Name | Dr Brian Tillis |
---|---|
Gender | Male |
Speciality | Obstetrics/gynecology |
Experience | 8 Years |
Location | 9555 76th St Ste 4105, 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 |
---|---|---|---|
1396107405 | NPI | - | NPPES |
69543-20 | Other | WI | WI LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 69543-20 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
United Hospital System | Kenosha, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Froedtert South Inc | 9537071196 | 122 |
Entity Name | Froedtert South Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558305284 PECOS PAC ID: 9537071196 Enrollment ID: O20031103000493 |
Mailing Address | Practice Location Address |
---|---|
Dr Brian Tillis, MD 9555 76th St # 4105, Pleasant Prairie, WI 53158-1984 Ph: (262) 577-8080 | Dr Brian Tillis, MD 9555 76th St Ste 4105, Pleasant Prairie, WI 53158-1984 Ph: (262) 577-8080 |
Michael A Schellpfeffer, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 9555 76th Street, Pleasant Prairie, WI 53158 Phone: 262-577-8080 Fax: 262-577-8081 | |
Dr. Kelli Louise Sasada, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 9555 76th St, Suite 4105, Pleasant Prairie, WI 53158 Phone: 262-577-8080 Fax: 262-577-8081 | |
Thomas M Ambro, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 9555 76th St Ste 4105, Pleasant Prairie, WI 53158 Phone: 262-577-8080 Fax: 262-577-8081 | |
Dr. Caroline Eleonora Bednarski, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 9555 76th St # 4105, Pleasant Prairie, WI 53158 Phone: 262-577-8080 |