| Sixteenth Street Community Health Centers | |
|
309 E North St Waukesha WI 53188-3718 | |
| (414) 672-1353 | |
| (262) 408-5094 |
| Full Name | Sixteenth Street Community Health Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 309 E North St, Waukesha, Wisconsin |
| Authorized Official Name and Position | Credentialing Specia M Stamps (CFO) |
| Authorized Official Contact | 4146721353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sixteenth Street Community Health Centers Po Box 778789 Chicago IL 60677-8789 Ph: (414) 672-1353 | Sixteenth Street Community Health Centers 309 E North St Waukesha WI 53188-3718 Ph: (414) 672-1353 |
| NPI Number | 1144593815 |
|---|---|
| Provider Enumeration Date | 02/10/2012 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/16/2024 |
| Medicare PECOS PAC ID | 6709876857 |
|---|---|
| Medicare Enrollment ID | O20121212000285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144593815 | NPI | - | NPPES |
| 100024527 | Medicaid | WI | |
| 1144593815 | Medicaid | WI |
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