EASTERN WISCONSIN MEDICAL COMPANY S.C. (NPI# 1831604081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831604081 |
| Entity Type | Organization |
| Organization Name | EASTERN WISCONSIN MEDICAL COMPANY S.C. |
| Practice Address |
245 S Executive Dr Ste 350 Brookfield WI 53005-4214 |
| Mailing Address |
2001 Butterfield Rd Ste 300 Downers Grove IL 60515-1069 |
| Practice Telephone | 2623731647 |
| Practice Fax Number | 2623731650 |
| Mailing Telephone | 6307252700 |
| Mailing Fax Number | 6307252783 |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2018-03-14 |
| Authorized Official Name | JOSHUA REZNIK (DIRECTOR) |
| Authorized Official Telephone | 6307252894 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 202K00000X | Phlebology | Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100074290 | 05 |
| Street Address |
245 S EXECUTIVE DR STE 350 |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-4214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851692339 | Robert Harold Sewell | Surgery | 17760 Gebhardt Rd, Brookfield, WI 53045-5031 | 2010-11-15 |
| 1497065262 | David L Heber | Surgery | 19635 Wellington Ct, Brookfield, WI 53045 | 2010-10-14 |
| 1992702823 | Pepito C Rivera | Surgery | 130 East Lockling Avenue, Brookfield, MO 64628 | 2005-07-07 |
| 1164498549 | Robert Brodish | Surgery | 1350 S Sunny Slope Rd, Brookfield, WI 53005-7060 | 2006-02-27 |
| 1598745051 | David J Engstrand | Surgery | 17000 W North Ave, Ste 107w, Brookfield, WI 53005-4423 | 2006-01-20 |
| 1154301513 | Bobby Wu | Surgery | 17000 W North Ave, Ste 107w, Brookfield, WI 53005-4423 | 2006-01-20 |
| 1093795171 | John S Blackwood | Surgery | 17000 W North Ave, Ste 107w, Brookfield, WI 53005-4423 | 2006-01-17 |
| 1770563868 | Manfred C Chiang | Surgery | 17000 W North Ave, Ste 107w, Brookfield, WI 53005-4423 | 2006-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861969149 | Watertown Physician Practices LLC | Surgery | 123 Hospital Dr Ste 2009, Watertown, WI 53098-3320 | 2018-10-25 |
| 1356847644 | Laura K Krecko | Surgery | Uw Hospital and Clinics 600 Highland Avenue, Madison, WI 53792-0001 | 2018-04-04 |
| 1447785332 | Patrick Beard Schwartz | Surgery | Uw Hopsitals and Clinics, 600 Highland Ave., Madison, WI 53792-0001 | 2017-04-27 |
| 1700263720 | Marianna Dubovska | Surgery | 902 Riverside Dr Ste 201, Waupaca, WI 54981-1992 | 2015-04-28 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1972901262 | The Healthy Vein, Sc | Surgery | N79w14684 Appleton Ave, Menomonee Falls, WI 53051-4308 | 2014-12-18 |
| 1326453200 | Chey V Collura | Surgery | 2700 W 9th Ave Ste 310, Oshkosh, WI 54904 | 2014-06-30 |
| 1538570338 | Nicholas Sich | Surgery | 2901 W Kinnickinnic River Pkwy Dept Ste 540, Milwaukee, WI 53215-3677 | 2014-05-14 |
| Find all providers with the same taxonomy | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
Please comment or provide details below to improve the information on EASTERN WISCONSIN MEDICAL COMPANY S.C..
| 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.