| Sschc National Ave Clinic | |
|
1635 W National Ave Milwaukee WI 53204-1130 | |
| (414) 672-1353 | |
| (262) 408-5094 |
| Full Name | Sschc National Ave Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1635 W National Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Maria Cecilia S Taylor (CFO) |
| Authorized Official Contact | 4148036395 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sschc National Ave Clinic Po Box 778789 Chicago IL 60677-8789 Ph: (414) 672-1353 | Sschc National Ave Clinic 1635 W National Ave Milwaukee WI 53204-1130 Ph: (414) 672-1353 |
| NPI Number | 1316587439 |
|---|---|
| Provider Enumeration Date | 01/07/2020 |
| Last Update Date | 05/16/2023 |
| Certification Date | 05/16/2023 |
| Medicare PECOS PAC ID | 6709876857 |
|---|---|
| Medicare Enrollment ID | O20200224000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316587439 | NPI | - | NPPES |
| 1316587439 | Medicaid | WI | |
| 01545 | Other | WI | MEDICARE PIN |
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