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Mary Eldridge, M.D.
NPI 1063673903 · General Practice Physician · Kenosha, WI
Mary Eldridge, M.D. is a General Practice Physician provider in Kenosha, WI (NPI 1063673903).
Provider details
- NPI number
- 1063673903
- Entity type
- Individual
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 54685-20 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1400 75th St
Suite #5
Kenosha, WI 53143-1544
Phone: (262) 656-1911
Fax: (888) 316-8458
Street-level locationGet directions
Mailing address
1400 75th St
Kenosha, WI 53143-1544
Registry dates
- Enumerated
- 2008-06-23
- Last updated
- 2015-09-19
Frequently asked questions
- What is Mary Eldridge's NPI number?
- Mary Eldridge's National Provider Identifier (NPI) is 1063673903, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mary Eldridge's specialty?
- Mary Eldridge is listed in the NPPES registry with a primary specialty of General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Mary Eldridge located?
- Mary Eldridge's practice location on file with NPPES is 1400 75th St, Kenosha, WI 53143-1544.
- What is Mary Eldridge's phone number?
- The practice phone number listed in the NPPES registry for Mary Eldridge is (262) 656-1911.
- Is Mary Eldridge's NPI active?
- Yes — Mary Eldridge's NPI (1063673903) is active in the NPPES registry as of the last update on 2015-09-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.