Healthcare Provider Details

I. General information

NPI: 1336227834
Provider Name (Legal Business Name): JEFFREY T SABATINO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17280 W NORTH AVE STE 200
BROOKFIELD WI
53045-4366
US

IV. Provider business mailing address

17280 W NORTH AVE STE 200
BROOKFIELD WI
53045-4366
US

V. Phone/Fax

Practice location:
  • Phone: 262-240-9640
  • Fax: 262-293-9659
Mailing address:
  • Phone: 262-240-9640
  • Fax: 262-293-9659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38986-21
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number38986-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: