Organization
CHILDREN'S MEDICAL GROUP
Active
Parent organization
CHILDREN'S MEDICAL GROUP
Other names
Greensquare South
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S MEDICAL GROUP
Authorized official
SMRITI KHARE M.D. (PRESIDENT, CHILDREN'S MEDICAL GROUP)
(414) 266-7615
Entity
Organization
Contact information
Practice address
7300 S 13TH ST, SUITE 201, OAK CREEK, WI 53154-1832
(414) 228-4800
(414) 247-0894
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
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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