JASNA CORALIC (NPI# 1528296753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528296753 |
| Entity Type | Individual |
| Full Name | JASNA CORALIC |
| Credential | MD |
| Practice Address |
2350 N Lake Dr Suite 304 Milwaukee WI 53211-4528 |
| Mailing Address |
788 N Jefferson St Suite 300/attn. Kaaren Butzen Milwaukee WI 53202-3718 |
| Practice Telephone | 4142987233 |
| Practice Fax Number | 4142987229 |
| Mailing Telephone | 4142728950 |
| Mailing Fax Number | 4142720859 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2016-11-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 62416-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 208C00000X | Colon & Rectal Surgery | 62416-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1528296753 | 05 |
| Street Address |
2350 N LAKE DR SUITE 304 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-4528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194721407 | Nguyen H Phan | Internal Medicine | 2350 N Lake Dr, Ste 206, Milwaukee, WI 53211-4528 | 2005-06-22 |
| 1326650698 | Dylan Henry Menefee | Physician Assistant | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2020-08-18 |
| 1659936169 | Cadie Leigh Roszak | Nurse Practitioner | 2350 N Lake Dr, Milwaukee, WI 53211-4528 | 2019-05-09 |
| 1457884165 | Shelly A. Boyd | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2017-04-10 |
| 1043663818 | Kelly Brock | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-18 |
| 1376996397 | Jennifer Gallagher | Physician Assistant | 2350 N Lake Dr, Suite 206, Milwaukee, WI 53211-4528 | 2016-07-14 |
| 1104285873 | Catherine Bares | Nurse Practitioner | 2350 N Lake Dr, Suite 100, Milwaukee, WI 53211-4528 | 2016-02-23 |
| 1578921375 | Heather Bastjan | Nurse Practitioner | 2350 N Lake Dr, Suite 500, Milwaukee, WI 53211-4528 | 2016-02-08 |
| 1033586292 | Angela Kraus | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-08-24 |
| 1871974964 | Tatyana Trendafilova Radulovic | Nurse Practitioner | 2350 N Lake Dr, Suite 302, Milwaukee, WI 53211-4528 | 2015-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
| Find all providers in zip 53211 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619177870 | Amy Jean Hanna-salami | Colon & Rectal Surgery | 2801 W Kinnickinnic River Pkwy Ste 330, Milwaukee, WI 53215-3678 | 2007-07-24 |
| 1356636781 | Molly W Meyers | Colon & Rectal Surgery | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215 | 2011-06-14 |
| 1972828929 | Jed F Calata | Colon & Rectal Surgery | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2010-04-01 |
| 1508895335 | Rudolph M. Kluiber | Colon & Rectal Surgery | 3003 W Good Hope Rd, Milwaukee, WI 53209-2042 | 2006-07-02 |
| 1467420653 | James V Klas | Colon & Rectal Surgery | 2801 W Kk River Pkwy, Suite 330, Milwaukee, WI 53215-3669 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023100484 | David Joseph Matteucci | Colon & Rectal Surgery | 5004 22nd Ave, Kenosha, WI 53140-5923 | 2006-09-29 |
| 1053424853 | Peter Michael Falk | Colon & Rectal Surgery | 670 Cormier Road, Green Bay, WI 54304-4824 | 2006-08-16 |
| 1699714485 | Christopher T Smith | Colon & Rectal Surgery | 14555 W. National Ave, #192, New Berlin, WI 53151-8414 | 2006-06-06 |
| 1669727921 | Therese G. Kerwel | Colon & Rectal Surgery | 17000 W North Ave, Suite 107w, Brookfield, WI 53005-4423 | 2012-07-23 |
| 1174636062 | Scott Lewis Ruggles | Colon & Rectal Surgery | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2006-08-16 |
| 1265412365 | Theresa K Hayssen | Colon & Rectal Surgery | 17000 W North Ave, Ste 107w, Brookfield, WI 53005-4423 | 2006-01-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.