Provider Demographics
NPI:1831345057
Name:EICHENSEER, SHEILA
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:EICHENSEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W129N7055 NORTHFIELD DR
Mailing Address - Street 2:COMMUNITY MEMORIAL MEDICAL COMMONS
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-0538
Mailing Address - Country:US
Mailing Address - Phone:262-253-2510
Mailing Address - Fax:262-253-3399
Practice Address - Street 1:W129N7055 NORTHFIELD DR
Practice Address - Street 2:COMMUNITY MEMORIAL MEDICAL COMMONS
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-0538
Practice Address - Country:US
Practice Address - Phone:262-253-2510
Practice Address - Fax:262-253-3399
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0530392084N0400X
WI610962084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1831345057Medicaid