Lara N Mrak, MD | |
1032 E Sumner St, Hartford, WI 53027-1608 | |
(262) 673-2300 | |
Not Available |
Full Name | Lara N Mrak |
---|---|
Gender | Female |
Speciality | Diagnostic Radiology |
Experience | 10 Years |
Location | 1032 E Sumner St, Hartford, 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 |
---|---|---|---|
1063832608 | NPI | - | NPPES |
100047720 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0204X | Radiology - Vascular & Interventional Radiology | 66081 (Wisconsin) | Secondary |
2085R0202X | Radiology - Diagnostic Radiology | 66081 - 20 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Aurora Medical Center - Summit | Summit, WI | Hospital |
Aurora St Lukes Medical Center | Milwaukee, WI | Hospital |
Aurora Medical Ctr Washington County | Hartford, WI | Hospital |
Aurora Medical Center - Grafton | Grafton, WI | Hospital |
Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Aurora Advanced Healthcare Inc | 3375625833 | 928 |
Aurora Medical Group, Inc. | 6709794258 | 3269 |
Lakeshore Medical Clinic Llc | 7719890730 | 293 |
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 |
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 |
---|---|
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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Lara N Mrak, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Lara N Mrak, MD 1032 E Sumner St, Hartford, WI 53027-1608 Ph: (262) 673-2300 |