MEDICARE: PREFERRED MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1043161417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED MEDICAL LLC

Provider Business Mailing Address
First Line	:	5678 W BROWN DEER RD STE 1B
Second Line	:
City	:	BROWN DEER
State	:	WI
Zip	:	53223-2365
Country	:	US
Telephone Number	:	414-817-2055
Fax Number	:

Provider Business Practice Location Address
First Line	:	5678 W BROWN DEER RD STE 1B
Second Line	:
City	:	BROWN DEER
State	:	WI
Zip	:	53223-2365
Country	:	US
Telephone Number	:	414-817-2055
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW SEBULIBA
Credential	:
Telephone Number	:	414-817-2055

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/05/2026

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Directions to “PREFERRED MEDICAL LLC ” Practice Location

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