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
Phone: (920) 720-2300
Fax: (920) 720-3806
Website:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043494578 | NPPES |
| Wisconsin | MEDICAID | 43567900 |
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