Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063673903 Individual Practitioner Female Practitioner

Dr. Mary Patricia Eldridge , MD

General Practice • Kenosha, WI

Professional Overview & Biography Verified Profile Summary

Dr. Mary Eldridge, MD is a registered healthcare professional specializing in General Practice in Kenosha, WI. Practice services are available at 1400 75TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1400 75th St
Suite #5

Kenosha, WI 531431544

Telephone 2626561911
Fax 8883168458
Associated Practice Facility / Clinic
🏢 E John Eldridge Md Sc Facility NPI 1073610242

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Kenosha, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 29.4 Yrs
Regional Practice Density
1 Specialists

Practicing in Kenosha, WI (130 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License WI 54685-20

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

14 Associated Practitioners
NPI 1013660687

Licensed Professional Counselor

Nina Orlando

Counselor - Mental Health

NPI 1205678232
Meghan Janer

Counselor - Professional

NPI 1265241145
Sara Cummings

Social Worker

NPI 1326753237
Tylor Rockwell

Nurse Practitioner - Psychiatric/Mental Health

NPI 1336909100
Denise Gilanyi , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1346941606

Psychiatric-Mental Health Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 19, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location September 19, 2015

Registered at 1400 75TH ST, SUITE #5, KENOSHA, WI 531431544 (Tel: 2626561911)

📍
Updated Business Mailing Address September 19, 2015

Registered at 1400 75TH ST, SUITE #5, KENOSHA, WI 531431544 (Tel: 2626561911)

👤
Provider Name / Credentials Updated September 19, 2015

Recorded as MARY ELDRIDGE, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 19, 2015

General Practice (License #54685-20 in WI)

🟢
Initial NPI Registration & Enumeration June 23, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063673903
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 23, 2008
Last Update: September 19, 2015
Sole Proprietor: Yes

Mailing Address

1400 75th St, Suite #5

Kenosha, WI 531431544

Phone: 2626561911

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.