Organization
NORTHSHORE CLINIC & CONSULTANTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESE A JAECKLE APNP (CLINICAL DIRECTOR)
(262) 375-1116
Entity
Organization
Contact information
Practice address
W62N248 WASHINGTON AVE, SUITE #207, CEDARBURG, WI 53012-2768
(262) 375-1116
(262) 375-1071
Mailing address
W62N248 WASHINGTON AVE, SUITE #207, CEDARBURG, WI 53012-2768
(262) 375-1116
(262) 375-1071
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1695
WI
Other
Enumeration date
04/11/2007
Last updated
04/19/2011
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