Organization
DRS DECHECK AND MATACZYNSKI MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK E DECHECK MD (PRESIDENT)
(262) 634-6679
Entity
Organization
Contact information
Practice address
3805 B SPRING STREET, SUITE 250, RACINE, WI 53405
(262) 634-6679
(262) 634-7935
Mailing address
3805B SPRING ST, SUITE 250, MOUNT PLEASANT, WI 53405-1641
(262) 634-6679
(262) 634-7935
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000 90530
MEDICARE NUMBER FOR CORPORATION
WI
01
—
25991
LICENSE
WI
01
—
27946
LICENSE
WI
05
—
30593800
—
WI
05
—
30772700
—
WI
Enumeration date
11/10/2006
Last updated
04/22/2015
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