Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Family Medical Clinic SC

Organization Primary Care Clinic/Center · NPI 1861857542

Providence Family Medical Clinic SC is a Primary Care Clinic/Center in Glendale, Wisconsin. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

2500 W Silver Spring Dr
Glendale, WI 53209-4218
Phone: (414) 800-7171
Fax: (414) 800-7166
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X

Record details

NPI number1861857542
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adedapo Okusanya — President · (269) 598-7404
NPI enumeratedDecember 22, 2015
Last updated in NPPESDecember 22, 2015
Mailing address2500 W Silver Spring Dr, Glendale, WI 53209-4218

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