Provider Demographics
NPI:1588970206
Name:WHEATON FRANCISCAN HOSPITAL
Entity type:Organization
Organization Name:WHEATON FRANCISCAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LADHANI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:262-687-2699
Mailing Address - Street 1:1320 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1978
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1320 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1978
Practice Address - Country:US
Practice Address - Phone:262-687-2699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health