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MEDCO MILWAUKEE LLC
NPI 1306542394
Nurse Practitioner in Mequon, WI

Active since February 01, 2023CLIA 52D2318294 · Waiver
1340 W TOWNE SQUARE RD STOP 5, MEQUON, WI 53092(262) 292-8101 Get Directions Write a Review

NPPES record last updated: February 1, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Medco Milwaukee Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDCO MILWAUKEE LLC (NPI 1306542394) is a healthcare organization registered as a nurse practitioner in Mequon, Wisconsin and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through February 6, 2027 and lists Dmitriy Chester, Owner, as its authorized official.

NPPES Registry Identity

NPI1306542394
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameMEDCO MILWAUKEE LLC
Location Address1340 W TOWNE SQUARE RD STOP 5Mequon, WI 53092-5076
Mailing Address1340 W Towne Square Rd Stop 5Mequon, WI 53092-5076 · (262) 292-8101
Phone(262) 292-8101
Organization SubpartNo
Authorized OfficialDmitriy ChesterOwner · (262) 292-8101
Enumeration DateFebruary 1, 2023
NPPES CertifiedFebruary 1, 2023
✔ NPI 1306542394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1340 W TOWNE SQUARE RD STOP 5, Mequon, WI 53092
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Other Names 1

Doing Business AsMedco Milwaukee Llc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2318294

Medco Milwaukee LLC · Mequon, WI
Active · expires Feb 6, 2027
CLIA Number52D2318294
Laboratory TypePhysician Office
Certificate Effective DateFebruary 7, 2025
Certificate Expiration DateFebruary 6, 2027
Laboratory DirectorDmitriy Chester
Laboratory Phone(262) 292-8101
Laboratory LocationMedco Milwaukee LLC1340 W Towne Square Rd Ste 5, Mequon, WI 53092
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DMITRIY B CHESTER NP
Nurse Practitioner (Family)
1340 W TOWNE SQUARE RD STOP 5
MEQUON, WI 53092
Ozaukee County (262) 292-8101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medco Milwaukee LLC's NPI number?

The NPI number for Medco Milwaukee LLC is 1306542394. It was assigned to this organization in the NPPES registry on February 1, 2023.

Where is Medco Milwaukee LLC located?

Medco Milwaukee LLC is located at 1340 W Towne Square Rd Stop 5, Mequon, WI 53092. The listed phone number is (262) 292-8101.

What is Medco Milwaukee LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Medco Milwaukee LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2318294) is associated with this NPI, valid through February 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Medco Milwaukee LLC was last updated on February 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.