Emily Kathleen Wilczak, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036136945 Issued in IL

Practice address

N2950 Wi-67
Lake Geneva, WI 53147

Phone

(815) 229-7580

NPI assigned

Mar 31, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Michigan State University College of Human Medicine

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Walworth Hospital & Medical Center Hospital, Lake Geneva, WI, CCN 521357

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603

  IL

  Medicare reassignment NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  Medicare reassignment NPD
• Mercy Harvard Hospital Inc

  • Critical Access Hospital
  • Harvard, IL
  • NPI 1427001445
  Medicare reassignment NPD
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD
• Mercy Harvard Hospital Inc

  • Skilled Nursing Facility
  • Harvard, IL
  • NPI 1124195557
  NPD
• Mercy Health System Corporation

  • Prosthetic/Orthotic Supplier
  • Lake Geneva, WI
  • NPI 1710124698
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1386969400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2950 WI-67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "53147",
            "telephone_number": "608-756-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2950 WI-67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "53147",
            "telephone_number": "815-229-7580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 South Route 31",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600148190",
            "country_code": "US",
            "telephone_number": "779-220-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Grant St",
            "address_purpose": "LOCATION",
            "city": "Harvard",
            "state": "IL",
            "postal_code": "600331821",
            "country_code": "US",
            "telephone_number": "815-943-5431",
            "fax_number": "815-943-0659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILCZAK",
        "first_name": "EMILY",
        "middle_name": "KATHLEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036136945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lance W Weldgen Jr.
• Andrew Wesolowski
• Stefanie N Weyenberg, DPT
• Richard C White, DDS
• Robert Wilson White, D.D.S.
• Abbigayle Jordan Willgruber, MD
• Cathy M Williamson, OT ASSISTANT
• Macy Kay Winkelman, PT
• Wisconsin CVS Pharmacy LLC
• Wisconsin Illinois Senior Housing Inc.

• Surgery Physician in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.