Elizabeth Ann Wickstrom (NPI# 1952473118, PAC ID# 4284731662) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1952473118 |
| PAC ID by PECOS | 4284731662 |
| Professional Enrollment ID | I20080711000027 |
| Full Name | Elizabeth Ann Wickstrom |
| Organization Legal Name | OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA |
| Address |
9100 W 74th St Shawnee Mission KS 66204-4004 |
| Phone Number | 9136762000 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 7214009851 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 170104 | SHAWNEE MISSION MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 10500 Quivira Rd, Overland Park, KS 66215-2306 | 9134986000 | OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA |
| 9100 W 74th St, Shawnee Mission, KS 66204-4004 | 9136762000 | OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA |
| Organization Legal Name | OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven N Weindling | Cardiovascular Disease (cardiology) | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | 4401 Wornall Rd, Kansas City, MO 64111-3220 |
| Tracy A Cowles | Obstetrics/gynecology | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | 12200 W 106th St, Suite 110, Overland Park, KS 66215-2305 |
| Brent E Finley | Obstetrics/gynecology | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | 12200 W 106th St, Suite 110, Overland Park, KS 66215-2305 |
| Ashley D Melton | Physician Assistant | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Laura C Behler | Nurse Practitioner | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | 10550 Quivira Rd, Suite 520, Overland Park, KS 66215-2307 |
| Cecily A Clark Ganheart | Obstetrics/gynecology | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | 4401 Wornall Rd, Kansas City, MO 64111-3220 |
| Jillian R Richard | Nurse Practitioner | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | 10550 Quivira Rd, Suite 520, Overland Park, KS 66215-2307 |
| Street Address |
9100 W 74TH ST |
| City | SHAWNEE MISSION |
| State | KS |
| Zip | 66204-4004 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rebecca Bliss Ryan Milholland | Neurology | Shawnee Mission Medical Center Inc | 9100 W 74th St, Ahmg Cardiology At Shawnee Mission, Merriam, KS 66204-4004 |
| Shawna L Vanleeuwen | Nurse Practitioner | Shawnee Mission Medical Center Inc | 9100 W 74th St, Ahmg Cardiology At Shawnee Mission, Merriam, KS 66204-4004 |
| Lisa A Pazdernik | Obstetrics/gynecology | Shawnee Mission Medical Center Inc | 9100 W 74th St, Ahmg Cardiology At Shawnee Mission, Merriam, KS 66204-4004 |
| Sherif A Ragab | Psychiatry | Shawnee Mission Medical Center Inc | 9100 W 74th St, Ahmg Cardiology At Shawnee Mission, Merriam, KS 66204-4004 |
| Guillermo J Couchonnal | Infectious Disease | 9100 W 74th St, Shawner Mission Medical Center, Shawnee Mission, KS 66204-4004 | |
| Piyushkumar Jani | Psychiatry | Shawnee Mission Medical Center Inc | 9100 W 74th St, Ahmg Cardiology At Shawnee Mission, Merriam, KS 66204-4004 |
| Bruce D Graham | Colorectal Surgery (proctology) | 9100 W 74th St, Shawnee Mission Medical Center, Shawnee Mission, KS 66204-4004 | |
| Stephen N Rosenberg | Physical Medicine and Rehabilitation | Rehab Consultants Pa | 9100 W 74th St, Wound Care Center, Shawnee Mission, KS 66204-4004 |
| Mariana N Mack | Psychiatry | Shawnee Mission Medical Center Inc | 9100 W 74th St, Ahmg Psychiatry At Shawnee Mission, Merriam, KS 66204-4004 |
| Lisa Dawn Crough | Nurse Practitioner | Shawnee Mission Medical Center Inc | 9100 W 74th St, Ahmg Cardiology At Shawnee Mission, Merriam, KS 66204-4004 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel S Mitchell | Anesthesiology | Midwest Anesthesia Associates, Pa | 7315 E Frontage Rd, Suite 140, Merriam, KS 66204-1600 |
| Gregory A Trempy | Anesthesiology | Midwest Anesthesia Associates, Pa | 7315 E Frontage Rd, Suite 140, Merriam, KS 66204-1600 |
| Jonathan E Ferns | Anesthesiology | Midwest Anesthesia Associates, Pa | 7315 E Frontage Rd, Suite 140, Merriam, KS 66204-1600 |
| Melanie L Yunger | Nurse Practitioner | Midwest Anesthesia Associates, Pa | 7315 E Frontage Rd, Suite 140, Merriam, KS 66204-1600 |
| Timothy R Lair | Anesthesiology | Midwest Anesthesia Associates, Pa | 7315 E Frontage Rd, Suite 140, Merriam, KS 66204-1600 |
| Stacy Forrestt | Physician Assistant | Midwest Anesthesia Associates, Pa | 7315 E Frontage Rd, Suite 140, Merriam, KS 66204-1600 |
| Kimberly A Cochran | Neurology | Shawnee Mission Medical Center Inc | 7301 E Frontage Rd, Merriam, KS 66204-1632 |
| Albert T Chmielewski | Family Practice | Shawnee Mission Medical Center Inc | 7301 E Frontage Rd, Merriam, KS 66204-1632 |
| Jason K Bessey | Family Practice | Shawnee Mission Medical Center Inc | 7301 E Frontage Rd, Merriam, KS 66204-1632 |
| Lauren J Bessey | Family Practice | Shawnee Mission Medical Center Inc | 7301 E Frontage Rd, Merriam, KS 66204-1632 |
| Find all physicians in zip 66204 | |||
| City | SHAWNEE MISSION |
| Zip Code | 66204 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | SHAWNEE MISSION + OBSTETRICS/GYNECOLOGY |
Please comment or provide details below to improve the information on Elizabeth Ann Wickstrom.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.