| Jonathan E Kiechle, | |
|
2424 S 90th St, West Allis, WI 53227 | |
| (414) 649-1280 | |
| Not Available |
| Full Name | Jonathan E Kiechle |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 15 Years |
| Location | 2424 S 90th St, West Allis, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083903512 | NPI | - | NPPES |
| 100079599 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 68601 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| West Allis Memorial Hospital | West allis, WI | Hospital |
| Aurora St Lukes Medical Center | Milwaukee, WI | Hospital |
| Aurora Medical Center - Grafton | Grafton, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Advanced Healthcare, Inc. | 3375625833 | 1012 |
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| 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 | Aurora Advanced Healthcare, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan E Kiechle, Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Jonathan E Kiechle, 2424 S 90th St, West Allis, WI 53227 Ph: (414) 649-1280 |
Mr. Anand Patel, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2424 S 90th St Fl 3, West Allis, WI 53227 Phone: 414-328-8150 | |
Jamie Hsien-chin Chao, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 8905 W Lincoln Ave, Ste 405, West Allis, WI 53227 Phone: 414-329-5650 Fax: 414-329-5670 |