MEDICARE: MRS. MARY ELIZABETH PETOSKEY MS/CCC-SLP

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	235Z00000X	Speech-Language Pathologist	419-154	WI

General Provider Information

NPI Number	:	1265706444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY ELIZABETH PETOSKEY MS/CCC-SLP

Provider Business Mailing Address
First Line	:	10945 N. PORT WASHINGTON RD.
Second Line	:	SUITE 211
City	:	MEQUON
State	:	WI
Zip	:	53092-0000
Country	:	US
Telephone Number	:	262-241-8000
Fax Number	:	262-241-8096

Provider Business Practice Location Address
First Line	:	2900 W. OKLAHOMA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-0000
Country	:	US
Telephone Number	:	414-649-7772
Fax Number	:	414-649-7977

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2012
Last Update Date	:	12/13/2021

Similar Medicare Providers

1851355051 — EMMYLOU SWARTZ O.D.
Practice Location Address:

5000 W NATIONAL AVE
MILWAUKEE, WI
53295-0000

Practice Phone: 414-384-2000
Practice Fax:

1053355156 — KAREN GVENTER
Practice Location Address:

2025 E NEWPORT AVE , COLUMBIA ST MARY'S HOSPITAL
MILWAUKEE, WI
53201-0000

Practice Phone: 441-961-4164
Practice Fax:

1164592150 — UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Practice Location Address:

3351 N DOWNER AVE.
MILWAUKEE, WI
53211-0000

Practice Phone: 414-229-6643
Practice Fax: 414-229-6608

1437220902 — DR. DOUGLAS CHUNG D.C
Practice Location Address:

9820 N MILWAUKEE AVE , UNIT C & D
DES PLAINES, IL
60016-0000

Practice Phone: 815-458-6597
Practice Fax: 815-458-7934

1598473662 — YASMINE HELPING HANDS
Practice Location Address:

4719 N 79TH ST
MILWAUKEE, WI
53218-0000

Practice Phone: 414-748-5311
Practice Fax:

1679282727 — YASMINE PRENATAL CARE
Practice Location Address:

4719 N 79TH ST
MILWAUKEE, WI
53218-0000

Practice Phone: 414-748-5311
Practice Fax:

Directions to “ MRS. MARY ELIZABETH PETOSKEY MS/CCC-SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.