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Contact Information

KELLI ICEMAN, DPM
8805 PINE RIDGE DR
CADILLAC, MI49601-7064
 Phone: 231-779-3668
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for KELLI ICEMAN · (Female)

NPI Number 1386008787
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 04/12/2016
Last updated 09/24/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 1137
Hospital affiliation(s)
  • ASPIRUS WAUSAU HOSPITAL - (Acute Care)
    333 PINE RIDGE BLVD
    WAUSAU, WI 54401
  • MERITER HSPTL - (Acute Care)
    202 S PARK ST
    MADISON, WI 53715
  • UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY - (Acute Care)
    600 HIGHLAND AVENUE
    MADISON, WI 53792
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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