Nominate a provider



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HealthEOS Office Locations

301 N. Broadway, Suite 301
P.O. Box 6090
De Pere, WI 54115

18650 W. Corporate Dr., Suite 310
Brookfield, WI 53045-6344

If you would like to recommend a health care provider who is not already participating with HealthEOS, or if you are a provider interested in joining the network, please complete and submit the form below and we’ll initiate the application process when appropriate. Of course, all providers must meet our credentialing standards to ensure the best quality network available.

Name	*
Company
Address	*
City	*
State/Province	*
Zip Code	*
Email Address
Work Phone	*
Fax Number
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