Provider Demographics
NPI:1447471677
Name:ZIKOS, AGGELIKI (MD)
Entity type:Individual
Prefix:DR
First Name:AGGELIKI
Middle Name:
Last Name:ZIKOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 E MORELAND BLVD
Mailing Address - Street 2:WESTBROOK HEALTH CENTER
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-2939
Mailing Address - Country:US
Mailing Address - Phone:262-532-5700
Mailing Address - Fax:262-532-5701
Practice Address - Street 1:2315 E MORELAND BLVD
Practice Address - Street 2:WESTBROOK HEALTH CENTER
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-2939
Practice Address - Country:US
Practice Address - Phone:262-532-5700
Practice Address - Fax:262-532-5701
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125051683207R00000X
WI51651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1447471677Medicaid
WI680860546Medicare PIN
WI1447471677Medicaid