1003021452 NPI number — ASPIRUS MEDICAL GROUP, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003021452 NPI number — ASPIRUS MEDICAL GROUP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPIRUS MEDICAL GROUP, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASPIRUS WOMENS HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003021452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29980 NETWORK PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60673-1299
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-847-2304
Provider Business Mailing Address Fax Number:
715-843-1188

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 PINE RIDGE BLVD
Provider Second Line Business Practice Location Address:
SUITE 185
Provider Business Practice Location Address City Name:
WAUSAU
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54401-4120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-847-0477
Provider Business Practice Location Address Fax Number:
715-847-0409
Provider Enumeration Date:
05/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PECK
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
VP REVENUE CYCLE
Authorized Official Telephone Number:
715-847-2988

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com