| Dr Verona Maierhofer Ittiara, MD | |
|
701 Grove Ave, Wild Rose, WI 54984-6901 | |
| (920) 622-3257 | |
| Not Available |
| Full Name | Dr Verona Maierhofer Ittiara |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 22 Years |
| Location | 701 Grove Ave, Wild Rose, 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 |
|---|---|---|---|
| 1538248455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 1905-850 (Wisconsin) | Secondary |
| 207P00000X | Emergency Medicine | 2012033510 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Alton Memorial Hospital | Alton, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southeastern Emergency Physicians Of Memphis Llc | 5395643209 | 76 |
| Entity Name | Alton-griffin Emergency Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891104824 PECOS PAC ID: 7315167103 Enrollment ID: O20140929002428 |
| Entity Name | Southeastern Emergency Physicians Of Memphis Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437105277 PECOS PAC ID: 5395643209 Enrollment ID: O20150520001245 |
| Entity Name | Ahs Il Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659098101 PECOS PAC ID: 5496111676 Enrollment ID: O20230512001300 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Verona Maierhofer Ittiara, MD 701 Grove Ave, Wild Rose, WI 54984-6901 Ph: (920) 622-5560 | Dr Verona Maierhofer Ittiara, MD 701 Grove Ave, Wild Rose, WI 54984-6901 Ph: (920) 622-3257 |
Timothy R Roberts, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 601 Grove Ave, Wild Rose, WI 54984 Phone: 920-622-3257 | |
Joseph M Leon, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 601 Grove Ave, Wild Rose, WI 54984 Phone: 920-622-3257 Fax: 920-622-6021 |