# PROHEALTH MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROHEALTH MEDICAL GROUP INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114966231
- **Legal business name:** PROHEALTH MEDICAL GROUP INC
- **Authorized official:** BRIAN T LIPMAN MD (PRESIDENT CLINIC DIVISION)
- **Authorized official phone:** (262) 928-8669

## Contact information

- **Practice address:** N16W24131 RIVERWOOD DR, WAUKESHA, WI 53188-1106
- **Practice address phone:** (262) 696-0808
- **Mailing address:** 725 AMERICAN AVE, MEDICAL STAFF OFFICE, WAUKESHA, WI 53188-5031
- **Mailing address phone:** (262) 928-3270
- **Mailing address fax:** (262) 953-8723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 06/05/2006
- **Last updated:** 05/23/2022