Healthcare Provider Details

I. General information

NPI: 1790696524
Provider Name (Legal Business Name): ABILI HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W SILVER SPRING DR STE B
GLENDALE WI
53209-4218
US

IV. Provider business mailing address

W131N6610 CRESTWOOD DR
MENOMONEE FALLS WI
53051-8316
US

V. Phone/Fax

Practice location:
  • Phone: 414-628-5392
  • Fax:
Mailing address:
  • Phone: 414-628-5392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HENRIETTA C ABILI
Title or Position: MANAGING MEMBER
Credential: DNP
Phone: 414-628-5392