| Independent Physicians Of Wisconsin, Llc | |
|
5434 W Capitol Dr Ste 3 Milwaukee WI 53216-2298 | |
| (414) 875-0505 | |
| Not Available |
| Full Name | Independent Physicians Of Wisconsin, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5434 W Capitol Dr Ste 3, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Mohammad Qasim Khan (MANAGING MEMBER) |
| Authorized Official Contact | 4148750505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independent Physicians Of Wisconsin, Llc 5434 W Capitol Dr Ste 3 Milwaukee WI 53216-2298 Ph: (414) 875-0505 | Independent Physicians Of Wisconsin, Llc 5434 W Capitol Dr Ste 3 Milwaukee WI 53216-2298 Ph: (414) 875-0505 |
| NPI Number | 1871975920 |
|---|---|
| Provider Enumeration Date | 06/25/2015 |
| Last Update Date | 05/06/2021 |
| Medicare PECOS PAC ID | 3274842034 |
|---|---|
| Medicare Enrollment ID | O20151016001548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871975920 | NPI | - | NPPES |
| Provider Name | Awais H Siddique |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1649387846 PECOS PAC ID: 3375430812 Enrollment ID: I20040301000679 |
| Provider Name | Hector M Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952389876 PECOS PAC ID: 1456343458 Enrollment ID: I20040406000824 |
| Provider Name | Nikki J Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043235153 PECOS PAC ID: 5698768141 Enrollment ID: I20040408000441 |
| Provider Name | Waleed Najeeb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407879877 PECOS PAC ID: 2860309796 Enrollment ID: I20040518001033 |
| Provider Name | Chad F Tamez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548342371 PECOS PAC ID: 7517944853 Enrollment ID: I20040702001187 |
| Provider Name | Timothy W Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720007271 PECOS PAC ID: 0941288559 Enrollment ID: I20040709001407 |
| Provider Name | Ganesh N Pulla |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1679620918 PECOS PAC ID: 0345218384 Enrollment ID: I20040920000113 |
| Provider Name | Brian Wolter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588638498 PECOS PAC ID: 9234187758 Enrollment ID: I20050111000421 |
| Provider Name | Gary S Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194762765 PECOS PAC ID: 6608828157 Enrollment ID: I20050214000308 |
| Provider Name | Kamal Amin |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1265406516 PECOS PAC ID: 8820031941 Enrollment ID: I20050608001149 |
| Provider Name | Kirsten L O Quinn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841237781 PECOS PAC ID: 0446294060 Enrollment ID: I20050615000112 |
| Provider Name | Jeff A Kleiner |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1194712232 PECOS PAC ID: 5294761151 Enrollment ID: I20050712000662 |
| Provider Name | Brian S Woodbridge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720055817 PECOS PAC ID: 7315971868 Enrollment ID: I20050923000241 |
| Provider Name | Jaspal S Arora |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1699783282 PECOS PAC ID: 8729073739 Enrollment ID: I20051208000732 |
| Provider Name | Barbara Ann Hummel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972519361 PECOS PAC ID: 0244131431 Enrollment ID: I20070516000486 |
| Provider Name | Sharee Lanee Chance-lawson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659498822 PECOS PAC ID: 2365406014 Enrollment ID: I20071112000298 |
| Provider Name | Fernando Itable |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871586560 PECOS PAC ID: 2769395466 Enrollment ID: I20080913000168 |
| Provider Name | Mark R Kroll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124030499 PECOS PAC ID: 5395804025 Enrollment ID: I20081110000356 |
| Provider Name | Aymen M Khogali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689851412 PECOS PAC ID: 6507916699 Enrollment ID: I20090611000285 |
| Provider Name | Carey M Cameron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710067178 PECOS PAC ID: 6507906823 Enrollment ID: I20091217000508 |
| Provider Name | Maqbool Arshad |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518999655 PECOS PAC ID: 0143352344 Enrollment ID: I20100723000665 |
| Provider Name | Mohammad Q Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104892868 PECOS PAC ID: 2466485305 Enrollment ID: I20100819001146 |
| Provider Name | Malik S Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124037437 PECOS PAC ID: 0840486569 Enrollment ID: I20101119001171 |
| Provider Name | Kshama Keshava Bhat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255526190 PECOS PAC ID: 4385830322 Enrollment ID: I20101202000110 |
| Provider Name | Donna J Hayes |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225045651 PECOS PAC ID: 1456412543 Enrollment ID: I20120328001001 |
| Provider Name | Natalya Puckett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942436399 PECOS PAC ID: 5496905127 Enrollment ID: I20121015000679 |
| Provider Name | Byung Geun Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114326758 PECOS PAC ID: 6507188190 Enrollment ID: I20141210001333 |
| Provider Name | Julie B Waisbren |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699017855 PECOS PAC ID: 9234435181 Enrollment ID: I20160622002544 |
| Provider Name | Vicki Milroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730679804 PECOS PAC ID: 2668723594 Enrollment ID: I20180915000147 |
| Provider Name | Syed A Rizvi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477968584 PECOS PAC ID: 0547581811 Enrollment ID: I20190724000903 |
| Provider Name | Jennifer L Macgregor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144869942 PECOS PAC ID: 2769818772 Enrollment ID: I20200212000013 |
| Provider Name | Araceli Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861086480 PECOS PAC ID: 8820404361 Enrollment ID: I20210309001518 |
| Provider Name | Seema A Afsari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114287141 PECOS PAC ID: 8123335080 Enrollment ID: I20220405002828 |
| Provider Name | Saadia Ghazal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922735570 PECOS PAC ID: 2668858242 Enrollment ID: I20221005001264 |
| Provider Name | Hassan Homida |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073017695 PECOS PAC ID: 3779977103 Enrollment ID: I20230309000752 |
| Provider Name | Karen D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164125837 PECOS PAC ID: 4284080078 Enrollment ID: I20231031001650 |
| Provider Name | Theresa N Otu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770853574 PECOS PAC ID: 6204279177 Enrollment ID: I20240207002905 |
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