Allure Medical of Wisconsin PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

ALLURE MEDICAL OF WISCONSIN PLLC

Practice address

1930 W Bluemound Rd Ste 340
Waukesha, WI 53186

Phone

(262) 349-9371

Fax

(262) 408-5258

NPI assigned

Apr 25, 2018

Last updated

Sep 4, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

VEIN CENTER AT ALLURE MEDICAL SPA, PLLCAs reported in NPPES

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

Authorized official

Name

Charles K Mok, MD

Title

Physician/Owner

Phone

(586) 786-5900

Specialties & licenses 2

Addresses

Part of

Vein Center at Allure Medical Spa PLLC

Locations

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1881182889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8180 26 MILE RD STE 300",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483165139",
            "telephone_number": "586-786-5900",
            "fax_number": "586-992-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W BLUEMOUND RD STE 340",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53186",
            "telephone_number": "262-349-9371",
            "fax_number": "262-408-5258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1239 Corporate Center Dr",
            "address_purpose": "LOCATION",
            "city": "Oconomowoc",
            "state": "WI",
            "postal_code": "530664898",
            "country_code": "US",
            "telephone_number": "262-349-9371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLURE MEDICAL OF WISCONSIN PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VEIN CENTER AT ALLURE MEDICAL SPA, PLLC",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "MOK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "586-786-5900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanette Q Allen, BSN, RN
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• Alyssia Altobelli

• Vascular Surgery Physician in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Vascular Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.