Provider Demographics
NPI:1477660009
Name:ALLERGY RESEARCH & CARE SC
Entity Type:Organization
Organization Name:ALLERGY RESEARCH & CARE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HENRI
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-784-5431
Mailing Address - Street 1:350 GREEN TREE ROAD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-3815
Mailing Address - Country:US
Mailing Address - Phone:262-784-5431
Mailing Address - Fax:262-784-5472
Practice Address - Street 1:350 GREEN TREE ROAD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-3815
Practice Address - Country:US
Practice Address - Phone:262-754-5431
Practice Address - Fax:262-784-5472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI34325-020207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31925700Medicaid
WI31925700Medicaid
WI000001393Medicare PIN