| Milwaukee Psychiatric Physicians Chartered | |
|
12760 W North Ave Bldg A Brookfield WI 53005-4628 | |
| (262) 439-5500 | |
| (866) 439-5221 |
| Full Name | Milwaukee Psychiatric Physicians Chartered |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12760 W North Ave Bldg A, Brookfield, Wisconsin |
| Authorized Official Name and Position | Jackie Michels (PRACTICE MANAGER) |
| Authorized Official Contact | 2624395500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milwaukee Psychiatric Physicians Chartered 12760 W North Ave, Bldg A Brookfield WI 53005 Ph: (262) 439-5500 | Milwaukee Psychiatric Physicians Chartered 12760 W North Ave Bldg A Brookfield WI 53005-4628 Ph: (262) 439-5500 |
| NPI Number | 1588739155 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 07/21/2022 |
| Certification Date | 09/15/2020 |
| Medicare PECOS PAC ID | 0840249751 |
|---|---|
| Medicare Enrollment ID | O20070430000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588739155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Randall J Zblewski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154426617 PECOS PAC ID: 3274427794 Enrollment ID: I20040213000246 |
| Provider Name | Marina C Tierney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396858825 PECOS PAC ID: 2264413582 Enrollment ID: I20040525000107 |
| Provider Name | Brian M Fidlin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083720759 PECOS PAC ID: 7012986508 Enrollment ID: I20040930001034 |
| Provider Name | David L Wandschneider |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548377591 PECOS PAC ID: 9537336425 Enrollment ID: I20120119000527 |
| Provider Name | Sally R Lohs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396139671 PECOS PAC ID: 7012291180 Enrollment ID: I20170309001149 |
| Provider Name | Makenzie E Hatfield Kresch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043714009 PECOS PAC ID: 3173957883 Enrollment ID: I20200103001870 |
| Provider Name | Patrick J Triggiano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194880286 PECOS PAC ID: 6608936034 Enrollment ID: I20220111001758 |
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