Organization
LANGLADE HOSPITAL - HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY M YANG (SVP & CHIEF FINANCIAL OFFICER)
(715) 847-2526
Entity
Organization
Contact information
Practice address
112 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 626-2331
Mailing address
29980 NETWORK PL, CHICAGO, IL 60673-1299
(715) 847-2304
(715) 843-1188
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42062400
—
WI
Enumeration date
02/21/2007
Last updated
06/13/2024
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