| Wellbe Wisconsin SC | |
|
209 S Central Ave Ste 300 Marshfield WI 54449-2836 | |
| (312) 776-2412 | |
| Not Available |
| Full Name | Wellbe Wisconsin SC |
|---|---|
| Speciality | Internal Medicine |
| Location | 209 S Central Ave Ste 300, Marshfield, Wisconsin |
| Authorized Official Name and Position | Jeffrey Kang (CEO) |
| Authorized Official Contact | 3127762412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellbe Wisconsin SC 225 W Washington St Ste 1700 Chicago IL 60606-3404 | Wellbe Wisconsin SC 209 S Central Ave Ste 300 Marshfield WI 54449-2836 Ph: (312) 776-2412 |
| NPI Number | 1801622881 |
|---|---|
| Provider Enumeration Date | 09/09/2024 |
| Last Update Date | 09/09/2024 |
| Certification Date | 09/09/2024 |
| Medicare PECOS PAC ID | 3173051133 |
|---|---|
| Medicare Enrollment ID | O20250106000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801622881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Kristin G Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124454830 PECOS PAC ID: 2961630694 Enrollment ID: I20140102000365 |
| Provider Name | Tamara a Insteness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295143394 PECOS PAC ID: 8527287010 Enrollment ID: I20140916000420 |
| Provider Name | Cassie Kaur Dundon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831685395 PECOS PAC ID: 5092057661 Enrollment ID: I20190430003096 |
| Provider Name | Kelly Theresia Dassow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184359499 PECOS PAC ID: 7416324777 Enrollment ID: I20221031001290 |
| Provider Name | Nicholas Allan Lueddecke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952916108 PECOS PAC ID: 9032588546 Enrollment ID: I20221205003202 |
| Provider Name | Kirstin Casi Boquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255041307 PECOS PAC ID: 8527437342 Enrollment ID: I20221216001171 |
| Provider Name | Cindy Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558794156 PECOS PAC ID: 2668607649 Enrollment ID: I20240429001562 |
| Provider Name | Jeffrey Kang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710429410 PECOS PAC ID: 8729231261 Enrollment ID: I20250106000260 |
| Provider Name | Iyad Houshan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497773287 PECOS PAC ID: 3274538251 Enrollment ID: I20250207002586 |
| Provider Name | Julianne Bellavance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740232164 PECOS PAC ID: 3274895511 Enrollment ID: I20260601003515 |
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