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

Alan J Licup, MD

Individual provider Surgery Physician · NPI 1205048246

Alan J Licup, MD is a General Surgery in Pleasant Prairie, Wisconsin. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 2006, 20 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group and accepts Medicare assignment. Licensed in Illinois and Wisconsin.

Years since qualifying
20
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
IL, WI
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12500 Aurora Dr
Pleasant Prairie, WI 53158
Phone: (262) 854-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 66270-20 (WI)
Surgery Physician Taxonomy 208600000X · Licence 036128087 (IL)

Record details

NPI number1205048246
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 3, 2007
Last updated in NPPESOctober 7, 2025
Certification dateOctober 7, 2025
Mailing addressPo Box 735044, Chicago, IL 60673-5044

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 2006 (20 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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