| Dr Glen Bordak, MD | |
|
3801 Spring St, Racine, WI 53405-1667 | |
| (262) 687-4100 | |
| Not Available |
| Full Name | Dr Glen Bordak |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 40 Years |
| Location | 3801 Spring St, Racine, 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 |
|---|---|---|---|
| 1588683718 | NPI | - | NPPES |
| 31564100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 27568-020 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Froedtert Memorial Lutheran Hospital | Milwaukee, WI | Hospital |
| United Hospital System | Kenosha, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Medical College Of Wisconsin Inc | 2668384371 | 1902 |
| Entity Name | Columbia St Marys Hospital Milwaukee Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
| Entity Name | The Medical College Of Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699720086 PECOS PAC ID: 2668384371 Enrollment ID: O20031120000259 |
| Entity Name | Lakeview Health Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679254700 PECOS PAC ID: 2860847100 Enrollment ID: O20231006000899 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Glen Bordak, MD 1055 Prairie Dr # D, Racine, WI 53406-3971 Ph: (262) 898-7100 | Dr Glen Bordak, MD 3801 Spring St, Racine, WI 53405-1667 Ph: (262) 687-4100 |
Dr. Bradley Beggs, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 3801 Spring St, Racine, WI 53405 Phone: 262-898-7100 Fax: 262-898-7171 | |
Dr. Barbara L Earnest, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 3801 Spring St, Racine, WI 53405 Phone: 262-687-4100 | |
Dr. Lori Allen, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 3801 Spring St, Racine, WI 53405 Phone: 262-687-6624 |