Gerald L. Ignace Indian Health Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Milwaukee, WI
NPI 1023064086 · NPPES record last updated Aug 26, 2025
Key facts
- NPI
- 1023064086
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- GERALD L. IGNACE INDIAN HEALTH CENTER, INC.
- Practice address
- 930 W Historic Mitchell St
Milwaukee, WI 53204-3533 - Phone
- (414) 383-9526
- Fax
- (414) 649-6711
- NPI assigned
- May 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Maria Schulner
- Title
- Provider Enrollment
- Phone
- (414) 383-5103
Owners & managing parties with NPI records 1
-
Lyle Anthony Ignace, M.D.
Corporate family (same tax ID) 4
Practitioners 23
-
Ninah Divine, MD
-
Alaina Jane Hanks, LPC
-
Anthony L Mannila, APNP FNP-C
-
Dionna McFerrin, PMHNP-BC, AGPCNP-BC
-
Luke Wild, LPC
-
Lydia Biehr, APNP
-
Paul Ginkel, M.D.
-
Lyle Anthony Ignace, M.D.
-
Ellicia Wilder, LPC-IT, SAC-IT
-
Eugene F Braaksma, PHD
-
Tanya Scheidegger, MS, LPC, NCC
-
Erin Zingler, LPC
-
Bridget M Costigan, FNP
-
Mustansir Majeed, MD
-
Elizabeth R Sedgwick, DNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI
Federally qualified health center certification: CCN 521049
- Legal name
- GERALD L IGNACE INDIAN HEALTH CENTER INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 4, 2025
- Last certification
- Mar 4, 2025
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 930 W Historic Mitchell St
Milwaukee, WI 53204-3533
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Lyle Ignace |
W-2 Managing Employee |
Oct 21, 2013 | |
| Operational/Managerial Control | Oct 21, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040329000847 | WI | Part B Supplier - Clinic/Group Practice | 5799677282 |
Receives reassigned benefits from 22 practitioners Practice locations: Milwaukee, WI |
| O20250623001870 | WI | Part a Provider - Federally Qualified Health Center (FQHC) | 5799677282 | Practice locations: Milwaukee, WI |
National Provider Directory
- Tax ID family
- Gerald L Ignace Indian Health Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Community Health Clinic/Center | 261QC1500X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
930 W Historic Mitchell St
Milwaukee, WI 53204-3533
Mailing address
930 W Historic Mitchell St
Milwaukee, WI 53204-3533
Phone (414) 383-9526
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 093488131 | Other | WI | CHAMPUS |
| 32957100 | Medicaid | WI |
Other providers in Milwaukee, WI
- Alexander Ray Georgeson
- Glenn Dela Llana Gequillana
- Gail Lavoie Geraci
- Teresa Geraghty
- Gerald L Ignace Indian Dental Center, LLC
- Gerald L. Ignace Indian Health Center, Inc.
- Gerald L. Ignace Indian Health Center, Inc.
- Gerald L. Ignace Indian Health Center, Inc.
- Gerald L. Ignace Indian Health Center, Inc.
- Jennifer Faye Gerardin
All providers in Milwaukee, WI · Federally Qualified Health Center (FQHC) in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.