Provider Demographics
NPI:1518062132
Name:MIDWEST PULMONARY AND CRITICAL CARE ASSOCIATES
Entity Type:Organization
Organization Name:MIDWEST PULMONARY AND CRITICAL CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLUPSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-258-1511
Mailing Address - Street 1:2300 N MAYFAIR RD
Mailing Address - Street 2:SUITE 960
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1505
Mailing Address - Country:US
Mailing Address - Phone:414-258-1511
Mailing Address - Fax:414-258-3044
Practice Address - Street 1:2300 N MAYFAIR RD
Practice Address - Street 2:SUITE 960
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1505
Practice Address - Country:US
Practice Address - Phone:414-258-1511
Practice Address - Fax:414-258-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32724500Medicaid
WI02194Medicare ID - Type Unspecified