Organization
GERALD L. IGNACE INDIAN HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA SCHULNER (PROVIDER ENROLLMENT)
(414) 383-5103
Entity
Organization
Contact information
Practice address
930 W HISTORIC MITCHELL ST, MILWAUKEE, WI 53204-3533
(414) 383-9526
(414) 649-6711
Mailing address
930 W HISTORIC MITCHELL ST, MILWAUKEE, WI 53204-3533
(414) 383-9526
(414) 389-3881
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093488131
CHAMPUS
WI
05
—
32957100
—
WI
Enumeration date
05/25/2006
Last updated
08/26/2025
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