FACE AND SKIN LLC (NPI# 1366796583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366796583 |
| Entity Type | Organization |
| Organization Name | FACE AND SKIN LLC |
| Other Organization Name | EAR,NOSE,THROAT & PLASTIC SURGERY SPECIALIST |
| Practice Address |
4200 Savannah Dr De Forest WI 53532-2909 |
| Practice Telephone | 9208855225 |
| Practice Fax Number | 9203566419 |
| Mailing Telephone | 9208855225 |
| Mailing Fax Number | 9203566419 |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-09 |
| Authorized Official Name | DR. AYMEN D YAISH (OWNER) |
| Authorized Official Telephone | 9208855225 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | Y |
| Parent Organization Name | FACE AND SKIN LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ear,Nose,Throat & Plastic Surgery Specialist | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942524780 | Face and Skin LLC | Durable Medical Equipment & Medical Supplies | 130 Warren St, Suite 130, Beaver Dam, WI 53916-3062 | 2010-03-23 |
| Street Address |
4200 SAVANNAH DR |
| City | DE FOREST |
| State | WI |
| Zip Code | 53532-2909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033515283 | Ashley Dederich | Physical Therapy Assistant | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2014-11-17 |
| 1285067405 | Cayla Julia Schroeder | Physical Therapist | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2013-08-12 |
| 1720391410 | Judy Renee Klimt | Occupational Therapy Assistant | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2010-07-22 |
| 1619189339 | Elizabeth Groce | Physical Therapist | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2007-05-04 |
| 1871653485 | Mary Kirchberg | Occupational Therapist | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2006-12-12 |
| 1831257724 | Laura Ziegler | Physical Therapist | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2006-12-05 |
| 1295802510 | Ellen P Braatz | Physical Therapist | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2006-11-30 |
| 1740357060 | Cynthia K Devine | Physical Therapy Assistant | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2006-11-30 |
| 1720156888 | Kristy A Beyer | Physical Therapist | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2006-11-30 |
| 1205904372 | Chris Jaszewski | Physical Therapist | 4200 Savannah Dr, De Forest, WI 53532-2909 | 2006-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952650541 | Laura B Cole | Licensed Practical Nurse | 405 Anderson St., Deforest, WI 53532 | 2012-08-29 |
| 1043429707 | Tracy Beth Head | Pharmacist | 643 S. Main Street, Deforest, WI 53532 | 2007-05-21 |
| 1588702237 | Patricia Herschleb | Pharmacist | W6850 County Road Dm, De Forest, WI 53532 | 2007-02-02 |
| 1821147661 | Kathryn Marie Cacic | Nurse Practitioner | 7752 Clinton Road, Deforest, WI 53532 | 2007-01-10 |
| 1306915079 | Bakke Chiropractic Clinic Sc | Chiropractor | Bakke Chiropractic Clinic Sc, 312 East North Street, Deforest, WI 53532 | 2006-11-07 |
| 1689772485 | Gregg Nelson Bakke | Chiropractor | 312 East North Street, Bakke Chiropractic Clinic Sc, Deforest, WI 53532 | 2006-09-20 |
| 1730282344 | Deforest Dental Services | Dentist | 210 N. Main St., Ste 103, Deforest, WI 53532 | 2006-09-07 |
| 1326038670 | Trixie Irene Eakin | Optometrist | 101 S. Main St, De Forest, WI 53532 | 2005-10-27 |
| 1245663988 | Group Health Cooperative of South Central Wisconsin Deforest Clinic | Durable Medical Equipment & Medical Supplies | 815 S Main St, Deforest, WI 53532 | 2013-08-16 |
| 1205953866 | Essential Family Vision Care, S.c. | Optometrist | 101 S. Main St, De Forest, WI 53532 | 2007-03-26 |
| Find all providers in zip 53532 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104156 | Alliance Ent and Hearing Center, Sc | Otolaryngology | 2524 E Webster Place, Suite 201, Milwaukee, WI 53211-4257 | 2020-11-04 |
| 1962969915 | Alliance Ent & Hearing Center, S.c. | Otolaryngology | 2500 W Layton Ave Ste 230, Milwaukee, WI 53221-5421 | 2019-02-26 |
| 1851822076 | Fort Health Care Inc | Otolaryngology | 123 Hospital Dr Suite 106a, Watertown, WI 53098 | 2017-03-21 |
| 1184010977 | Chad Michael Ennis | Otolaryngology | 1 S Park St Fl 6, Madison, WI 53715-1375 | 2015-04-08 |
| 1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
| 1760803795 | Gary Miller | Otolaryngology | 3467 Northwood Rd, Suamico, WI 54313-8250 | 2013-12-17 |
| 1629320007 | Peter Uy Lee | Otolaryngology | 1341 Boundary Rd, Middleton, WI 53562-3843 | 2012-10-09 |
| 1700145091 | Kenneth Brian Lewoczko | Otolaryngology | 600 Highland Ave., H4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2012-05-08 |
| 1962768267 | Christopher Joseph Lee | Otolaryngology | 500 W. Drexel Ave, Suite 300, Oak Creek, WI 53154-2060 | 2012-04-11 |
| 1871814715 | Norval Eldred Bernhardt | Otolaryngology | 9 Holt Ct, Madison, WI 53719-3036 | 2010-06-15 |
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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.