PROGRESSIVE COMMUNITY HEALTH CENTERS, INC. (NPI# 1801262746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801262746 |
| Entity Type | Organization |
| Organization Name | PROGRESSIVE COMMUNITY HEALTH CENTERS, INC. |
| Other Organization Name | KILBOURN AVENUE HEALTH CENTER |
| Practice Address |
1218 W Kilbourn Ave Milwaukee WI 53233-1330 |
| Mailing Address |
Po Box 080257 Milwaukee WI 53208-8004 |
| Practice Telephone | 4149358000 |
| Practice Fax Number | 4143443396 |
| Mailing Telephone | 4149358000 |
| Mailing Fax Number | 4143443396 |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2017-02-01 |
| Authorized Official Name | MRS. CANDICE COLE (CFO) |
| Authorized Official Telephone | 4149358000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kilbourn Avenue Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023484961 | Progressive Community Health Centers, Inc. | Family Medicine | 945 N 12th St, Urgent Care, Milwaukee, WI 53233-1305 | 2015-08-14 |
| 1720153653 | Progressive Community Health Centers, Inc. | Family Medicine | 3522 W Lisbon Ave, Milwaukee, WI 53208-1953 | 2006-11-24 |
| Street Address |
1218 W KILBOURN AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53233-1330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003891250 | Aboud Affi | Internal Medicine | 1218 W Kilbourn Ave, Suite 404, Milwaukee, WI 53233-1330 | 2005-12-09 |
| 1932633724 | Lori L Leidel | Nurse Practitioner | 1218 W Kilbourn Ave, Milwaukee, WI 53233-1330 | 2017-04-18 |
| 1316287071 | Maia F Schwartz | Physician Assistant | 1218 W Kilbourn Ave, Suite 301, Milwaukee, WI 53233-1330 | 2013-02-18 |
| 1245532050 | Aurora Health Care Metro, Inc. | Public Health or Welfare | 1218 W Kilbourn Ave, Suite 207, Milwaukee, WI 53233-1330 | 2010-11-30 |
| 1235465832 | Richard R Wesley | Physician Assistant | 1218 W Kilbourn Ave, Suite 301, Milwaukee, WI 53233-1330 | 2009-11-02 |
| 1619202546 | Aurora Health Care Wic | Public Health or Welfare | 1218 W Kilbourn Ave, Suite 207, Milwaukee, WI 53233-1330 | 2009-10-09 |
| 1215167523 | Marvin | Surgery | 1218 W Kilbourn Ave, Suite-401, Milwaukee, WI 53233-1330 | 2009-07-21 |
| 1073754776 | Elisabeth Catherine Biggs | Physician Assistant | 1218 W Kilbourn Ave, Suite 511, Milwaukee, WI 53233-1330 | 2009-03-10 |
| 1306013834 | Patrick Walter Jost | Orthopaedic Surgery | 1218 W Kilbourn Ave, Suite 301, Milwaukee, WI 53233-1330 | 2008-05-14 |
| 1104003300 | Razan Khattab | Internal Medicine | 1218 W Kilbourn Ave, Ste 124, Milwaukee, WI 53233-1330 | 2008-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104454750 | Henok Desta Hardilo | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center 945 N 12th Street, Milwaukee, WI 53233 | 2020-03-30 |
| 1821633314 | Ann E Millard | Occupational Therapist | 560 N. 16th Street, Room 214a, Milwaukee, WI 53233 | 2019-11-08 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1356800478 | Nebiyu Abera Tilahun | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center, 945 N. 12th Street, Milwaukee, WI 53233 | 2019-03-18 |
| 1548748387 | Emily Claire Goetz | Physical Therapist | 945 N. 12th St. Suite 1100, Milwaukee, WI 53233 | 2018-08-03 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1184170706 | Lauren Troll | Physical Therapist | 925 N 12th Street, Milwaukee, WI 53233 | 2016-09-01 |
| 1942694401 | Iryna Nemesh | Internal Medicine | 1020 N 12th St Fl 2, Milwaukee, WI 53233 | 2015-03-23 |
| 1649676032 | Matina Angelopoulou | Dentist | 1801 West Winsconsin Ave, Milwaukee, WI 53233 | 2014-11-12 |
| 1780007831 | John Ladisa | Technician, Other | 1637 W. Wisconsin Ave, Room 311, Milwaukee, WI 53233 | 2014-01-27 |
| Find all providers in zip 53233 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942718762 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 2607 S 5th St, Milwaukee, WI 53207-1418 | 2018-01-15 |
| 1275056632 | Outreach Community Health Centers, Inc. | Clinic/Center | 9120 W Hampton Ave Ste 119, Milwaukee, WI 53225-4960 | 2017-07-18 |
| 1649559642 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 730 W Washington St., Milwaukee, WI 53204-2310 | 2011-08-08 |
| 1205318102 | Outreach Community Health Centers, Inc. | Clinic/Center | 1730 S 13th St, Milwaukee, WI 53204-3201 | 2018-09-06 |
| 1487144697 | Outreach Community Health Centers, Inc. | Clinic/Center | 1027 N 9th St, Milwaukee, WI 53233-1411 | 2018-05-14 |
| 1245720499 | Outreach Community Health Centers, Inc. | Clinic/Center | 1730 N 7th St, Milwaukee, WI 53205-1701 | 2018-05-14 |
| 1174910012 | Sixteenth Street Community Health Centers, Inc | Clinic/Center | 1727 S 9th St, Milwaukee, WI 53204-3519 | 2015-04-17 |
| 1528304797 | Sixteenth Street Community Health Center, Inc | Clinic/Center | 2906 S 20th St, Milwaukee, WI 53215-3732 | 2012-12-17 |
| 1316980709 | Milwaukee Health Services, Inc. | Clinic/Center | 2555 N Martin Luther King Dr, Milwaukee, WI 53212-2709 | 2006-06-14 |
| 1891732244 | Milwaukee Health Services Inc | Clinic/Center | 8200 W Silver Spring Dr, Attention: Tito Izard, M.d., Milwaukee, WI 53218-2552 | 2006-06-01 |
| Find all providers in MILWAUKEE | ||||
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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.