Gerald L. Ignace Indian Health Center, Inc.
Clinic/Center in Milwaukee, WI(View on Map)
Legal Business Name
Gerald L. Ignace Indian Health Center, Inc.
NPI Number
1023064086
NPI Type
Organization
Enumeration Date
05/25/2006
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
1711 SOUTH 11TH STREET
930 W HISTORIC MITCHELL ST
City
Milwaukee
Milwaukee
State
WI
WI
Postal Code
53204-3310
53204-3533
Country
US
US
Telephone Number
(414) 383-9526
(414) 383-9526
Authorized Official
Name
Lyle Ignace
Title or Position
EXECUTIVE DIRECTOR
Telephone Number
(414) 383-9526
Identifiers
Identifier
093488131
32957100
Identifier State
WI
WI
Identifier Issuer
CHAMPUS
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/13/2020
Provider Address
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