Jodi L Brehm, MD | |
10400 75th St, Kenosha, WI 53142 | |
(262) 648-5600 | |
(262) 948-5735 |
Full Name | Jodi L Brehm |
---|---|
Gender | Female |
Speciality | Surgical Oncology |
Experience | 23 Years |
Location | 10400 75th St, Kenosha, Wisconsin |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649216045 | NPI | - | NPPES |
036112238 | Medicaid | IL | |
35354900 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 036112238 (Illinois) | Secondary |
208600000X | Surgery | 52096 (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 | Ascension Medical Group-southeast Wisconsin Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
Entity Name | Aurora Medical Group, Inc. |
---|---|
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 |
---|---|
Jodi L Brehm, MD 10400 75th St, Kenosha, WI 53142-7884 Ph: (262) 648-5600 | Jodi L Brehm, MD 10400 75th St, Kenosha, WI 53142 Ph: (262) 648-5600 |
Dr. Mustafa Syed Badrudduja, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 6308 8th Ave, Suite 3050, Kenosha, WI 53143 Phone: 262-654-7002 Fax: 262-654-6822 | |
Timothy B Lesage, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-7380 | |
Dr. Roger Thomas Pacanowski, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-8217 |