| Dr Evan Charles Benner, DO | |
|
W231n1440 Corporate Ct, Waukesha, WI 53186-1303 | |
| (262) 896-6000 | |
| Not Available |
| Full Name | Dr Evan Charles Benner |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | W231n1440 Corporate Ct, Waukesha, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225532716 | NPI | - | NPPES |
| 100237346 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 74994-21 (Wisconsin) | Primary |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| 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 |
| Entity Name | Group Health Cooperative Of South Central Wisconsin |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245260165 PECOS PAC ID: 3870489586 Enrollment ID: O20040227000306 |
| Entity Name | Fort Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417993361 PECOS PAC ID: 0840189718 Enrollment ID: O20040319001411 |
| Entity Name | Aurora Advanced Healthcare, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
| Entity Name | Richland Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659301273 PECOS PAC ID: 7618861618 Enrollment ID: O20110318000356 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Evan Charles Benner, DO Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Dr Evan Charles Benner, DO W231n1440 Corporate Ct, Waukesha, WI 53186-1303 Ph: (262) 896-6000 |
Dr. Marc A Burrell, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: W231n1440 Corporate Ct, Waukesha, WI 53186 Phone: 262-896-6000 | |
Dr. David Joseph Czarnecki, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 725 American Ave, Waukesha, WI 53188 Phone: 262-928-2400 Fax: 262-928-7621 | |
Dr. Gregory Allen Kass, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 725 American Ave, Waukesha, WI 53188 Phone: 262-928-2400 Fax: 262-928-7621 | |
Dr. David Morgan Roelke, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 725 American Ave, Waukesha, WI 53188 Phone: 262-928-2400 Fax: 262-928-7621 | |
Dr. Jennifer T Bergin, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 725 American Ave, Waukesha, WI 53188 Phone: 262-928-2400 | |
Dr. David Orlin Yenerich, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 725 American Ave, Waukesha, WI 53188 Phone: 262-928-2400 Fax: 262-928-7621 | |
Bambi R Weyers, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: N16w24131 Riverwood Drive, Waukesha, WI 53188 Phone: 262-696-0696 Fax: 262-696-0683 |