Provider Demographics
NPI:1760560148
Name:OAK CREEK URGENT CARE LLC
Entity Type:Organization
Organization Name:OAK CREEK URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:LINDSEY
Authorized Official - Last Name:SKOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-570-1122
Mailing Address - Street 1:8201 S HOWELL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-8336
Mailing Address - Country:US
Mailing Address - Phone:414-570-1122
Mailing Address - Fax:414-570-1120
Practice Address - Street 1:8201 S HOWELL AVE STE 400
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-8336
Practice Address - Country:US
Practice Address - Phone:414-570-1122
Practice Address - Fax:414-570-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI208D00000X
WI261QU0200X261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI21309500Medicaid
WI261QU0200XOtherURGENT CARE