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Contact Information

ALYSSA S DEPPONG, PHYSICIAN ASSISTANT
12500 AURORA DR
PLEASANT PRAIRIE, WI53158-1227
 Phone: 262-857-5000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for ALYSSA S DEPPONG · (Female)

NPI # 1538721451
Status Active
Credentials PHYSICIAN ASSISTANT
Entity Individual
Enumeration date 07/01/2019
Last updated 12/05/2022 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 4736-23
  • WI Medicaid 100091500
Hospital affiliation(s)
  • WHEATON FRANCISCAN HEALTHCARE- ALL SAINTS - (Acute Care)
    3801 SPRING ST
    RACINE, WI 53405
  • WHEATON FRANCISCAN INC- ST JOSEPH - (Acute Care)
    5000 W CHAMBERS ST
    MILWAUKEE, WI 53210
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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