Organization
LANGLADE HOSPITAL - HOTEL DIEU OF ST JOSEPH OF ANTIGO WISCONSIN
Active
Other names
Aspirus Antigo Clinic
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
110 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-2351
Mailing address
29980 NETWORK PL, CHICAGO, IL 60673-1299
(715) 847-2304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
—
WI
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
WI
Other
Enumeration date
12/18/2006
Last updated
06/13/2024
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