Individual ProviderAlex PeroutkyStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186(414) 288-6790PECOS EnrollmentBased on the most recent information from CMS, provider Alex Peroutky does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1396205910Provider TypeIndividualFull NamePeroutky, AlexGenderMaleSole ProprietorNoEnumeration Date3/20/2019Last Updated3/20/2019Contact InformationPractice LocationPractice Address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186Phone(414) 288-6790FaxUnlisted FaxMailing LocationMailing Address2040 W Wisconsin Ave Apt L-604a, Milwaukee, WI 53233-2098PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerWisconsin