Search › Wisconsin › 207V00000X
Elana Wistrom, DO
NPI 1134376486 · on the registry since 2008
Practice
- Address
- 2825 Prairie Ave
Beloit, WI 53511 - Phone
- (608) 363-5500
- Fax
- (608) 363-5539
- Organisation at this address
- Mercy Health System Corporation
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 13
Registry record
- Primary taxonomy
- 207V00000X
207V00000X
- Also registered as
- 207V00000X
- Licence states on file
- MI, WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-01-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin