Children's Medical Group

NPI #1801061064 in Mequon, Wisconsin

Provider Information

NPI Number: 1801061064
Entity Type: Organization
Organization Name: Children's Medical Group
Subpart: Yes (part of a larger organization)
Parent Organization: CHILDREN'S MEDICAL GROUP
Primary Specialty: Pediatrics
Enumeration Date: Apr 28, 2008
Last Updated: Sep 24, 2021

Practice Location

Address: 1655 W. MEQUON ROAD
City: Mequon
State: Wisconsin
ZIP Code: 53092-3230
Phone: (262) 240-9744

Authorized Official

Name: DR. SMRITI KHARE, MD
Title: PRESIDENT, CHILDREN'S MEDICAL GROUP
Phone: (414) 266-7615

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X
Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent	103TC2200X
Social Worker	104100000X
Marriage & Family Therapist	106H00000X
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Psychiatry & Neurology - Child & Adolescent Psychiatry — Child & Adolescent Psychiatry	2084P0804X
Pediatrics	208000000X	Primary

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