MEDICARE: LEE ANDREW SIVELS

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	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care		WI

General Provider Information

NPI Number	:	1992642425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE ANDREW SIVELS

Provider Business Mailing Address
First Line	:	1270 CARDINAL LN APT A
Second Line	:
City	:	HOWARD
State	:	WI
Zip	:	54313-7154
Country	:	US
Telephone Number	:	920-634-5074
Fax Number	:

Provider Business Practice Location Address
First Line	:	1270 CARDINAL LN APT A
Second Line	:
City	:	HOWARD
State	:	WI
Zip	:	54313-7154
Country	:	US
Telephone Number	:	920-634-5074
Fax Number	:

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

Provider Enumeration Date	:	05/01/2026
Last Update Date	:	05/01/2026

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Directions to “ LEE ANDREW SIVELS ” Practice Location

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