Organization
CHILDREN'S HOSPITAL OF WISCONSIN
Active
Parent organization
CHILDREN'S HOSPITAL OF WISCONSIN
Other names
Child Advocacy Center - Lakeshore
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S HOSPITAL OF WISCONSIN
Authorized official
SHEILA REUTEMAN (SR. CREDENTIALING COORDINATOR)
(414) 266-7615
Entity
Organization
Contact information
Practice address
134 S FOSTER DR, SAUKVILLE, WI 53080-2005
(262) 358-9080
(262) 268-2040
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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