MILWAUKEE INDONESIA MEDICAL CLINIC (NPI# 1366814162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366814162 |
| Entity Type | Organization |
| Organization Name | MILWAUKEE INDONESIA MEDICAL CLINIC |
| Other Organization Name | INDONESIA MEDICAL CLINIC |
| Practice Address |
6300 N 76th St Ste 250 Milwaukee WI 53218-1208 |
| Practice Telephone | 4144464660 |
| Mailing Telephone | 4144464660 |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2016-11-14 |
| Authorized Official Name | HERR YANG (PRESIDENT) |
| Authorized Official Telephone | 4143971654 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| N | 183500000X | Pharmacist | Pharmacy Service Providers | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Indonesia Medical Clinic | Doing Business As Name - Organization |
| Street Address |
6300 N 76TH ST STE 250 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53218-1208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417571050 | Kaak Living | Clinic/Center | 5938 N 76th Street, Milwaukee, WI 53218 | 2020-05-29 |
| 1306495064 | Jeanette Bearden | Technician | 4477 N 57 St., Milwaukee, WI 53218 | 2019-09-05 |
| 1770074080 | Sunvale Homes LLC | Home Health | 4714 N 58th St, Milwaukee, WI 53218 | 2018-05-22 |
| 1447740006 | Quantum Care LLC | Home Health | 6424 W Fondulac Avenue, Unit 1, Milwaukee, WI 53218 | 2018-05-18 |
| 1811413008 | Ewura Asie Amonoo | Case Manager/Care Coordinator | 5153 W. Silver Spring, Milwaukee, WI 53218 | 2017-08-18 |
| 1649706714 | Life Tree Pharmacy LLC | Pharmacy | 8329-5 W Appleton Ave, Milwaukee, WI 53218 | 2017-05-10 |
| 1720524341 | Nastassia S Jackson | Counselor | 6830 W Villard Ave Ste 190, Milwaukee, WI 53218 | 2017-01-07 |
| 1801330493 | Mary Beth Cafaro | Social Worker | 5555 N. 51st Blvd, Milwaukee, WI 53218 | 2016-12-15 |
| 1669823613 | Lasonya Carol Wilson | Licensed Practical Nurse | 5830 N 75th St, Milwaukee, WI 53218 | 2016-06-30 |
| 1225302243 | Drew Douglas Cannon | Social Worker | 5555 N 51st Street, Milwaukee, WI 53218 | 2012-03-08 |
| Find all providers in zip 53218 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194337212 | Accident and Injury Rehab Center, Inc | Clinic/Center | 6114 W Capitol Dr Ste 100-102, Milwaukee, WI 53216-2147 | 2020-08-19 |
| 1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
| 1154889749 | Positive Directions Inc | Clinic/Center | 3510 W Saint Paul Ave # 6, Milwaukee, WI 53208-4125 | 2019-03-04 |
| 1255844106 | Comprehensive Diagnostic Imaging of Wisconsin, LLC | Clinic/Center | 2500 W Layton Ave Ste 20, Milwaukee, WI 53221-5400 | 2017-11-14 |
| 1265980767 | Wisconsin Healthcare Services | Clinic/Center | 2462 West Lisbon Avenue, Milwaukee, WI 53205 | 2016-09-14 |
| 1861859902 | Wisconsin Healthcare Network LLC | Clinic/Center | 5600 W Brown Deer Rd Ste 228, Milwaukee, WI 53223-2311 | 2016-01-20 |
| 1801229653 | Sixteen Street Community Health Center | Clinic/Center | 1337 S Cesar E Chavez Dr, Milwaukee, WI 53204-2712 | 2013-08-15 |
| 1821333550 | Milwaukee Spine and Joint Center | Clinic/Center | 1631 W Lincoln Ave, Milwaukee, WI 53215-2637 | 2012-12-06 |
| 1003175316 | Healing Center of Milwaukee | Clinic/Center | 5800 W Forest Home Ave, Milwaukee, WI 53220-1954 | 2012-05-07 |
| 1437472172 | Physician Associates of Wisconsin, Sc | Clinic/Center | 7033 Wellauer Dr, Milwaukee, WI 53213-3734 | 2010-03-09 |
| Find all providers in MILWAUKEE | ||||
Please comment or provide details below to improve the information on MILWAUKEE INDONESIA MEDICAL CLINIC.
| 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.