Healthcare Provider Details

I. General information

NPI: 1164161477
Provider Name (Legal Business Name): MADISON A TEICH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADISON HESSE DO

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2651 HILLCREST DRIVE
HUDSON WI
54016-4439
US

IV. Provider business mailing address

2651 HILLCREST DRIVE SUITE 303
HUDSON WI
54016-4439
US

V. Phone/Fax

Practice location:
  • Phone: 715-531-6800
  • Fax: 715-531-6801
Mailing address:
  • Phone: 715-531-6800
  • Fax: 715-531-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number81977
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number82134
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: