Provider Demographics
NPI:1043558703
Name:CHILDREN'S HEALTH SYSTEM
Entity Type:Organization
Organization Name:CHILDREN'S HEALTH SYSTEM
Other - Org Name:CHILDREN'S URGENT CARE - MAIN CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER/CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-266-6401
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:MS 958
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-7615
Mailing Address - Fax:414-266-6238
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:URGENT CARE CLINIC
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-2280
Practice Address - Fax:414-266-1627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-30
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty