Individual provider · Type 1 NPI

Alan J. Licup, MD

Surgery Physician · Pleasant Prairie, WI

NPI number 1205048246 Active

Practice location

12500 Aurora Dr
Pleasant Prairie, WI 53158

Call (262) 854-5000 Map

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Specialties and licenses

Taxonomy	Code	License
Surgery Physician Primary	208600000X	66270-20 (WI)
Surgery Physician	208600000X	036128087 (IL)

Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…

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About NPI 1205048246

Alan J. Licup, MD's National Provider Identifier is 1205048246, issued on May 3, 2007. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Pleasant Prairie, WI. The record was last updated on Oct 7, 2025.