# PHOENIXC HEALTHCARE, SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821591710
- **Authorized official:** INDRAJIT CHOUDHURI MD (PRESIDENT)
- **Authorized official phone:** (708) 488-9515

## Contact information

- **Practice address:** 6121 GREEN BAY RD STE 100, KENOSHA, WI 53142-2931
- **Practice address phone:** (708) 488-9515
- **Mailing address:** 11168 N LAKE SHORE DR, MEQUON, WI 53092-5811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | NULL | Yes |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/16/2018
- **Last updated:** 03/16/2018