Johnathan B Reddick, APRN, CNP | |
N84w16889 Menomonee Ave, Menomonee Falls, WI 53051-2810 | |
(262) 251-7500 | |
Not Available |
Full Name | Johnathan B Reddick |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 3 Years |
Location | N84w16889 Menomonee Ave, Menomonee Falls, 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 |
---|---|---|---|
1245988781 | NPI | - | NPPES |
100250920 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 101031-875 (Wisconsin) | Primary |
363L00000X | Nurse Practitioner | 209023782 (Illinois) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Northwestern Lake Forest Hospital | Lake forest, IL | Hospital |
Northwestern Memorial Hospital | Chicago, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Northwestern Medical Faculty Foundation | 4587576814 | 3255 |
Aurora Medical Group, Inc. | 6709794258 | 3207 |
Entity Name | Northwestern Medical Faculty Foundation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346235314 PECOS PAC ID: 4587576814 Enrollment ID: O20031105000541 |
Mailing Address | Practice Location Address |
---|---|
Johnathan B Reddick, APRN, CNP Po Box 735044, Chicago, IL 60673-5044 Ph: (262) 251-7500 | Johnathan B Reddick, APRN, CNP N84w16889 Menomonee Ave, Menomonee Falls, WI 53051-2810 Ph: (262) 251-7500 |
Debra J Casper, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Menomonee Falls, WI 53051 Phone: 262-257-3510 | |
David J. Luber, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: N84w16889 Menomonee Ave, Menomonee Falls, WI 53051 Phone: 262-251-7500 Fax: 262-251-7128 | |
Jamie Ottow, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: W129n7055 Northfield Dr, Menomonee Falls, WI 53051 Phone: 414-805-7000 | |
Arlene L Vlieger, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Menomonee Falls, WI 53051 Phone: 262-251-1000 | |
Anne Mutitu, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Menomonee Falls, WI 53051 Phone: 414-290-6720 Fax: 414-290-6755 | |
Emmy L Sippel, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: W180n8085 Town Hall Rd, Menomonee Falls, WI 53051 Phone: 262-257-2783 Fax: 262-250-7440 | |
Nicole Leigh Heding, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: W129n7055 Northfield Dr, Menomonee Falls, WI 53051 Phone: 414-430-4378 |