Kenneth Jason Heidle (NPI# 1083059604, PAC ID# 6901196880) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1083059604 |
| PAC ID by PECOS | 6901196880 |
| Professional Enrollment ID | I20170830000713 |
| Full Name | Kenneth Jason Heidle |
| Organization Legal Name | KENOSHA EMERGENCY PHYSICIANS LLC |
| Address |
6308 8th Ave Kenosha WI 53143-5031 |
| Phone Number | 4142906720 |
| Gender | M |
| Medical School | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 0143125708 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520021 | UNITED HOSPITAL SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 6308 8th Ave, Kenosha, WI 53143-5031 | 4142906720 | KENOSHA EMERGENCY PHYSICIANS LLC |
| 9555 76th St, Pleasant Prairie, WI 53158-1984 | 4142906720 | KENOSHA EMERGENCY PHYSICIANS LLC |
| 9555 76th St, Pleasant Prairie, WI 53158-1984 | 4694012386 | UNITED OCCUPATIONAL MEDICINE AND WALK IN SERVICES LLC |
| Organization Legal Name | KENOSHA EMERGENCY PHYSICIANS LLC |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren A Ingles | Physician Assistant | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Leo Treysman | Emergency Medicine | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| James J Kambol | Emergency Medicine | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Jessica A Lancaster | Emergency Medicine | Kenosha Emergency Physicians LLC | 9555 76th St, Pleasant Prairie, WI 53158-1984 |
| Stacy L Summers | Physician Assistant | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Gary J Zaid | Emergency Medicine | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Robert G Zick | Emergency Medicine | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Natalia Stasior | Emergency Medicine | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Brian M Huettl | Emergency Medicine | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Annessa F Retlick | Nurse Practitioner | Kenosha Emergency Physicians LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Street Address |
6308 8TH AVE |
| City | KENOSHA |
| State | WI |
| Zip | 53143-5031 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hanna Mariani | Endocrinology | Froedtert South Inc | 6308 8th Ave, Kenosha, WI 53143-5031 |
| John Anthony Martini | Family Medicine | Ihc Hospitalists LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Aimee C Ledesma | Family Medicine | Froedtert South Inc | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Mark Vytlacil | Pathology | Kenosha Pathology Consultants | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Michael Zeihen | Internal Medicine | Froedtert South Inc | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Sarah Stasiewicz | Physician Assistant | Froedtert South Inc | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Andrew W Harron | Diagnostic Radiology | Ihc Kenosha Radiology LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Tomasz M Jarzembowski | Family Medicine | Ihc Hospitalists LLC | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Rick J Hutson | Anesthesiology | Midwest Physicians Anesthesia Service, Sc | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Timothy A Sanborn | Cardiovascular Disease (cardiology) | Froedtert South Inc | 6308 8th Ave, Kenosha, WI 53143-5031 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Bower | Optometry | Robert B. Bower, O.d., S.c. | 2301 75th St, Kenosha, WI 53143-1403 |
| Eugene John Eldridge | Ophthalmology | 1400 75th St, Kenosha, WI 53143-1544 | |
| Daniel Dashner | Clinical Social Worker | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Jennifer L Evancy | Clinical Social Worker | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Kemba M Banyard | Nurse Practitioner | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Tierney Voit | Clinical Social Worker | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Jonathan T Grapengieser | Psychologist, Clinical | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Leah J Featherstone | Psychologist, Clinical | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Renee M Andreoli | Nurse Practitioner | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Amy Macdonald Wojcik | Clinical Social Worker | Professional Services Group Inc. | 2108 63rd St, Kenosha, WI 53143-4454 |
| Find all physicians in zip 53143 | |||
| City | KENOSHA |
| Zip Code | 53143 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | KENOSHA + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Kenneth Jason Heidle.
| 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.