| |
2817 New Pinery Rd Portage WI 53901-9240 | |
(608) 742-4131 | |
(608) 742-6098 |
Full Name | |
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Speciality | General Acute Care Hospital |
Location | 2817 New Pinery Rd, Portage, Wisconsin |
Authorized Official Name and Position | Lori Peck (VP REVENUE CYCLE) |
Authorized Official Contact | 7158472988 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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29980 Network Pl Chicago IL 60673-1299 Ph: (608) 742-4131 | 2817 New Pinery Rd Portage WI 53901-9240 Ph: (608) 742-4131 |
NPI Number | 1124083894 |
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Provider Enumeration Date | 04/18/2006 |
Last Update Date | 08/22/2022 |
Medicare PECOS PAC ID | 5799684007 |
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Medicare Enrollment ID | O20040106000557 |
Identifier | Type | State | Issuer |
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1124083894 | NPI | - | NPPES |
11009500 | Medicaid | WI | |
1023054137 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1073596235 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1619966058 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1457334468 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1174508261 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1437132669 | Other | WV | INDIVIDUAL PHYSICIAN NPI |
1699959593 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1336122506 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1376527002 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1659589653 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1871576017 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1144203381 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1497738637 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1537142765 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1689657827 | Other | WI | INDIVIDUAL PHYSICIAN NPI |
1881677011 | Other | WI | INDIVIDUAL PHYSICIAN NPI |