Cisar, Jill M

Cisar, Jill M is an individual health care provider with primary practice located at 1095 Midway Rd , Menasha WI 54952-1115. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Cisar, Jill M can be contacted via phone (920) 720-2300.

Contact Information

Primary practice address
1095 Midway Rd Menasha WI 54952-1115
Fax: (920) 720-3806
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 966-121 Wisconsin

Profile Details

NPI number 1043494578
LBN Legal business name Cisar, Jill M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2007
Last updated Dec 4th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043494578 NPPES
Wisconsin MEDICAID 43567900

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