| Dr Agnes Prospere, MD | |
|
200 E Ryan Rd, Oak Creek, WI 53154-4563 | |
| (414) 570-3590 | |
| Not Available |
| Full Name | Dr Agnes Prospere |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 7 Years |
| Location | 200 E Ryan Rd, Oak Creek, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083241301 | NPI | - | NPPES |
| 100213444 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 80102-20 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lakeshore Medical Clinic Llc | 7719890730 | 325 |
| Entity Name | Lakeshore Medical Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Agnes Prospere, MD Po Box 735044, Chicago, IL 60673-4329 Ph: (414) 570-3590 | Dr Agnes Prospere, MD 200 E Ryan Rd, Oak Creek, WI 53154-4563 Ph: (414) 570-3590 |
Shereen Mohis, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 200 E Ryan Rd, Oak Creek, WI 53154 Phone: 414-570-3590 | |
Lakesha Luckett, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2330 E Chestnut Dr, Oak Creek, WI 53154 Phone: 414-397-2528 | |
Kandipati Sreenivasarao, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7901 S 6th St, Oak Creek, WI 53154 Phone: 414-346-8000 | |
Dr. Jessica Lynn Woznick, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7901 S 6th St, Oak Creek, WI 53154 Phone: 414-346-8000 Fax: 414-346-8010 | |
Andrew Brayer, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7901 S 6th St, Oak Creek, WI 53154 Phone: 414-346-8000 Fax: 414-346-8010 | |
Heather Butler, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8020 S Howell Ave, Oak Creek, WI 53154 Phone: 414-647-3920 |