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NPI 1861691149 · Otolaryngology Physician · Green Bay, WI
Provider details
- NPI number
- 1861691149
- Entity type
- Organization
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sally Jilot, Administrator(920) 965-4800
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
923 Eliza St
Green Bay, WI 54301-3234
Phone: (920) 965-4800
Fax: (920) 431-7024
Street-level locationGet directions
Mailing address
923 Eliza St
Green Bay, WI 54301-3234
Registry dates
- Enumerated
- 2007-07-16
- Last updated
- 2010-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.