Wildwood Family Clinic, Sc | |
535 Southing Grange Cottage Grove WI 53527-9338 | |
(608) 839-3515 | |
(608) 839-3541 |
Full Name | Wildwood Family Clinic, Sc |
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Speciality | Family Medicine |
Location | 535 Southing Grange, Cottage Grove, Wisconsin |
Authorized Official Name and Position | Sheryl Green (ADMINISTRATOR) |
Authorized Official Contact | 6082211501 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wildwood Family Clinic, Sc 535 Southing Grange Cottage Grove WI 53527-9338 Ph: (608) 839-3515 | Wildwood Family Clinic, Sc 535 Southing Grange Cottage Grove WI 53527-9338 Ph: (608) 839-3515 |
NPI Number | 1225115124 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 9537137484 |
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Medicare Enrollment ID | O20040920000493 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225115124 | NPI | - | NPPES |
32721000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Robert W Cambray |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194712786 PECOS PAC ID: 2961491931 Enrollment ID: I20040506001260 |
Provider Name | Sarah E Lowery |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538138904 PECOS PAC ID: 2567462583 Enrollment ID: I20061221000453 |
Provider Name | Donna M Frisque |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1710922166 PECOS PAC ID: 0749281459 Enrollment ID: I20070124000092 |
Provider Name | Susan E Hardel |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1023046232 PECOS PAC ID: 7416958137 Enrollment ID: I20070124000151 |
Provider Name | Kimberly J Devault |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1083659437 PECOS PAC ID: 0840291571 Enrollment ID: I20070124000273 |
Provider Name | Dorothy J Mallory |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1831139039 PECOS PAC ID: 7618979725 Enrollment ID: I20070202000099 |
Provider Name | Christina D Hook |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194946988 PECOS PAC ID: 6204928906 Enrollment ID: I20070827000354 |
Provider Name | Leila R Midelfort |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1891735841 PECOS PAC ID: 3779628292 Enrollment ID: I20100308000587 |
Provider Name | Robert Z Edwards |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659340719 PECOS PAC ID: 8921134164 Enrollment ID: I20100327000038 |
Provider Name | Karen Lentfer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245289008 PECOS PAC ID: 5395713259 Enrollment ID: I20101204000026 |
Provider Name | Lynda Siewert |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225087893 PECOS PAC ID: 1951379817 Enrollment ID: I20101204000031 |
Provider Name | Steven P Siewert |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861442931 PECOS PAC ID: 9931177896 Enrollment ID: I20110218000750 |
Provider Name | Jason A Hampton |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689838492 PECOS PAC ID: 4385813773 Enrollment ID: I20110801000331 |
Provider Name | Kristina K Nilsson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1083756282 PECOS PAC ID: 8729258793 Enrollment ID: I20110830000486 |
Provider Name | Bryan J Webster |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275845497 PECOS PAC ID: 3678708880 Enrollment ID: I20131024000584 |
Provider Name | Alexandra Ilkevitch |
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Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1750686648 PECOS PAC ID: 7517190424 Enrollment ID: I20140630001644 |
Provider Name | Andrew B Schmitt |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447543020 PECOS PAC ID: 4486873130 Enrollment ID: I20140912000049 |
Provider Name | Stuart Midthun Mitchell |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1730134958 PECOS PAC ID: 8022021294 Enrollment ID: I20150402000861 |
Provider Name | Anthony James Sturm |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619243474 PECOS PAC ID: 2466676770 Enrollment ID: I20150716001915 |
Provider Name | Julia G Mcmillen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194014316 PECOS PAC ID: 8921311887 Enrollment ID: I20160830002734 |
Provider Name | Stefanie Lynn Haima |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1912219122 PECOS PAC ID: 8325231814 Enrollment ID: I20161114002469 |
Provider Name | Anne Britt Reichhoff |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1639482953 PECOS PAC ID: 4284911793 Enrollment ID: I20170511000795 |
Provider Name | Sean Preisler |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1801288287 PECOS PAC ID: 3173870268 Enrollment ID: I20180720000165 |
Provider Name | Teresa Riley |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1396914172 PECOS PAC ID: 5698169506 Enrollment ID: I20220218000298 |
Sheryl Spitzer -resnick Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 251 East Cottage Grove Road, Cottage Grove, WI 53527 Phone: 608-839-3515 Fax: 608-839-3541 |