Carol Lynn Radovich, NP is a
Nurse Practitioner - Adult Health based in Jackson, Wisconsin. Carol Lynn Radovich is licensed to practice in Wisconsin (license number 8119-33) and her current practice location is
W197n17054 Stonewall Dr, Jackson, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(847) 922-9203.
NPI number for Carol Lynn Radovich is 1578511739 and her current mailing address is W197n17054 Stonewall Dr, Jackson, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1578511739.
Provider's Profile
| Full Name | Carol Lynn Radovich |
|---|
| Gender | Female |
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| Speciality | Nurse Practitioner - Adult Health |
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| Location | W197n17054 Stonewall Dr, Jackson, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1578511739
- Provider Enumeration Date: 05/04/2006
- Last Update Date: 05/01/2019
Medical Identifiers
Medical identifiers for Carol Lynn Radovich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578511739 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LA2200X | Nurse Practitioner - Adult Health | 209004029 (Illinois) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | 8119-33 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carol Lynn Radovich is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Carol Lynn Radovich, NP
W197n17054 Stonewall Dr,
Jackson, WI 53037
Ph: (847) 922-9203 | Carol Lynn Radovich, NP
W197n17054 Stonewall Dr,
Jackson, WI 53037
Ph: (847) 922-9203 |
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