| Vitae Health Medical Wisconsin Llc | |
|
6735 W Bradley Rd Milwaukee WI 53223-3325 | |
| (224) 777-8034 | |
| Not Available |
| Full Name | Vitae Health Medical Wisconsin Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6735 W Bradley Rd, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Amish Manu Patel (PRESIDENT) |
| Authorized Official Contact | 2247778034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitae Health Medical Wisconsin Llc 3450 Oakton St Ste 300 Skokie IL 60076-2951 Ph: (224) 777-8034 | Vitae Health Medical Wisconsin Llc 6735 W Bradley Rd Milwaukee WI 53223-3325 Ph: (224) 777-8034 |
| NPI Number | 1508483140 |
|---|---|
| Provider Enumeration Date | 06/30/2020 |
| Last Update Date | 09/30/2021 |
| Medicare PECOS PAC ID | 6901224773 |
|---|---|
| Medicare Enrollment ID | O20200910000995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508483140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gerald J Gilliland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700844529 PECOS PAC ID: 8729085402 Enrollment ID: I20061024000080 |
| Provider Name | Angelica Marina Luccia Colibri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760678031 PECOS PAC ID: 5799968293 Enrollment ID: I20110321000951 |
| Provider Name | Marie L Toole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366774663 PECOS PAC ID: 1254586043 Enrollment ID: I20130228000114 |
| Provider Name | Jonathan D Nolte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578977831 PECOS PAC ID: 5991020240 Enrollment ID: I20150210000218 |
| Provider Name | Rebecca Kinnunen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174937882 PECOS PAC ID: 2961704788 Enrollment ID: I20160111000633 |
| Provider Name | Krin S Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770976136 PECOS PAC ID: 7517262892 Enrollment ID: I20160224001701 |
| Provider Name | Daniel Dashner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144621376 PECOS PAC ID: 5698050573 Enrollment ID: I20170315001213 |
| Provider Name | Sara Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902316953 PECOS PAC ID: 1052647401 Enrollment ID: I20190724000143 |
| Provider Name | Julie Anne Driscoll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083012025 PECOS PAC ID: 1254632094 Enrollment ID: I20200106000953 |
| Provider Name | Zahra Shariff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538260492 PECOS PAC ID: 8527084128 Enrollment ID: I20200408003818 |
| Provider Name | Anna Terese Tuomi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306476452 PECOS PAC ID: 2567883325 Enrollment ID: I20200603000125 |
| Provider Name | Ebonie Myakee Zollicoffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376938209 PECOS PAC ID: 4183042583 Enrollment ID: I20200917000439 |
| Provider Name | Teresa Poprawski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861611345 PECOS PAC ID: 5496847063 Enrollment ID: I20211004000258 |
| Provider Name | Abbey Lynn Gwinnup |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346977758 PECOS PAC ID: 5294103727 Enrollment ID: I20221115000530 |
| Provider Name | Sarah Vogt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992220727 PECOS PAC ID: 6002280088 Enrollment ID: I20230314001382 |
| Provider Name | Dawn M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952909277 PECOS PAC ID: 8325412091 Enrollment ID: I20230320002067 |
| Provider Name | Malorie A Huguet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861174971 PECOS PAC ID: 6406219146 Enrollment ID: I20230829002976 |
| Provider Name | Kaitlin Zurick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265114961 PECOS PAC ID: 0446612097 Enrollment ID: I20240314000161 |
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