Enisa Hodzic, MD | |
1640 E Sumner St, Hartford, WI 53027-2684 | |
(262) 670-4000 | |
Not Available |
Full Name | Enisa Hodzic |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 1640 E Sumner St, Hartford, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285869560 | NPI | - | NPPES |
100023662 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 57244 (Wisconsin) | Primary |
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 |
Entity Name | Lakeshore Medical Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
Entity Name | Aurora Advanced Healthcare Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
Mailing Address | Practice Location Address |
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Enisa Hodzic, MD Po Box 735044, Chicago, IL 60673-5044 Ph: () - | Enisa Hodzic, MD 1640 E Sumner St, Hartford, WI 53027-2684 Ph: (262) 670-4000 |
Brianna Lynn Bobber, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1640 E Sumner St, Hartford, WI 53027 Phone: 262-670-4000 | |
Julie E Mossberg, Pediatrics Medicare: Medicare Enrolled Practice Location: 110 Lone Oak Ln, Hartford, WI 53027 Phone: 262-670-1800 | |
Dr. Ronald G Gritt, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1640 E Sumner St, Hartford, WI 53027 Phone: 262-670-4000 Fax: 262-670-4451 |