Provider Demographics
NPI:1841659935
Name:WHEATON FRANCISCAN HEALTHCARE-FRANCISCAN WOODS
Entity type:Organization
Organization Name:WHEATON FRANCISCAN HEALTHCARE-FRANCISCAN WOODS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OTR/OPERATIONAL REHAB MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGART
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:262-780-3813
Mailing Address - Street 1:19525 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4107
Mailing Address - Country:US
Mailing Address - Phone:262-785-1114
Mailing Address - Fax:
Practice Address - Street 1:19525 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4107
Practice Address - Country:US
Practice Address - Phone:262-785-1114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12441-24314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility