Jenna Sarantakos, DO | |
2000 E Layton Ave, St Francis, WI 53235-6053 | |
(414) 744-6589 | |
(414) 747-8848 |
Full Name | Jenna Sarantakos |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 2000 E Layton Ave, St Francis, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790309508 | NPI | - | NPPES |
100246712 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 81205 (Wisconsin) | Primary |
207Q00000X | Family Medicine | R-11880 (Iowa) | Secondary |
Entity Name | Lakeshore Medical Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
Mailing Address | Practice Location Address |
---|---|
Jenna Sarantakos, DO Po Box 735044, Chicago, IL 60673-5044 Ph: (414) 744-6589 | Jenna Sarantakos, DO 2000 E Layton Ave, St Francis, WI 53235-6053 Ph: (414) 744-6589 |
Masood Wasiullah, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2000 E Layton Ave, St Francis, WI 53235 Phone: 414-744-6589 Fax: 414-747-8848 | |
Jacquelyn Marie Spring, Family Medicine Medicare: Medicare Enrolled Practice Location: 2000 E Layton Ave, St Francis, WI 53235 Phone: 414-744-6589 | |
Asma Sayeed, M.D Family Medicine Medicare: Medicare Enrolled Practice Location: 2000 E Layton Ave Ste 130, St Francis, WI 53235 Phone: 414-744-6589 Fax: 414-747-8848 | |
Gina Sorina Dorneanu, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2000 E Layton Ave, St Francis, WI 53235 Phone: 414-744-6589 Fax: 414-747-8848 | |
Lloyd D Hughes, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2000 E Layton Ave, St Francis, WI 53235 Phone: 414-744-6589 Fax: 414-747-8848 | |
Danielle Therese Olsen, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2000 E Layton Ave, St Francis, WI 53235 Phone: 414-744-6589 | |
Sarang Baman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2000 E Layton Ave, #100, St Francis, WI 53235 Phone: 414-744-6589 Fax: 414-747-8848 |