Provider Demographics
NPI:1023416716
Name:ALLIANCE ENT & HEARING CENTER, S.C.
Entity type:Organization
Organization Name:ALLIANCE ENT & HEARING CENTER, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HABANEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-727-0910
Mailing Address - Street 1:201 N MAYFAIR RD
Mailing Address - Street 2:SUITE 515
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4216
Mailing Address - Country:US
Mailing Address - Phone:414-727-0910
Mailing Address - Fax:414-727-0920
Practice Address - Street 1:S69W15636 JANESVILLE RD
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-9330
Practice Address - Country:US
Practice Address - Phone:414-727-0910
Practice Address - Fax:414-727-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty