Organization
IHC-CALUMET EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY A CIERLIK (PRESIDENT & CHIEF OPERATING OFFICER)
(414) 290-6700
Entity
Organization
Contact information
Practice address
614 MEMORIAL DR, CHILTON, WI 53014-1568
(414) 290-6720
(414) 290-6755
Mailing address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140006671
WEA
WI
05
—
21285300
—
WI
01
—
610475500
OWCP
WI
Enumeration date
05/04/2006
Last updated
10/20/2008
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