| Progressive Medical Group | |
|
9120 W Capitol Dr Milwaukee WI 53222-1622 | |
| (414) 215-3500 | |
| (414) 215-3504 |
| Full Name | Progressive Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 9120 W Capitol Dr, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Jasvir Kailey (OWNER) |
| Authorized Official Contact | 4142513500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Medical Group 9120 W Capitol Dr Milwaukee WI 53222-1622 Ph: (414) 251-3500 | Progressive Medical Group 9120 W Capitol Dr Milwaukee WI 53222-1622 Ph: (414) 215-3500 |
| NPI Number | 1609464049 |
|---|---|
| Provider Enumeration Date | 12/31/2020 |
| Last Update Date | 07/19/2021 |
| Medicare PECOS PAC ID | 8628479649 |
|---|---|
| Medicare Enrollment ID | O20210629001119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609464049 | NPI | - | NPPES |
| 7171-33 | Other | WI | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jasvir Kailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861946386 PECOS PAC ID: 5395025852 Enrollment ID: I20161129002813 |
| Provider Name | Roland Oswald Willock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053372920 PECOS PAC ID: 0143609248 Enrollment ID: I20220621001162 |
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