Organization
CHILDREN'S HOSPITAL OF WISCONSIN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC CADIEUX (CORPORATE VP AND CFO)
(414) 266-6226
Entity
Organization
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-3518
(414) 266-2000
(414) 266-6409
Mailing address
PO BOX 1997, MILWAUKEE, WI 53201-1997
(414) 266-2000
(414) 266-6409
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
135
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11019700
—
WI
Enumeration date
09/20/2006
Last updated
03/29/2016
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