Provider Demographics
NPI:1700223849
Name:AURORA SINAI MEDICAL CENTER
Entity Type:Organization
Organization Name:AURORA SINAI MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMERGENCY MEDICINE PA RESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ARDELLINI
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:239-349-0621
Mailing Address - Street 1:W353 N6046 BAYSHORE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066
Mailing Address - Country:US
Mailing Address - Phone:239-349-0621
Mailing Address - Fax:
Practice Address - Street 1:W353N6046 BAYSHORE CIR
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-1820
Practice Address - Country:US
Practice Address - Phone:239-349-0621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital