Healthcare Provider Details

I. General information

NPI: 1013849710
Provider Name (Legal Business Name): KELLY SYLVAIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S PARK ST
MADISON WI
53715-1830
US

IV. Provider business mailing address

2602 FAHEY GLN
FITCHBURG WI
53711-9402
US

V. Phone/Fax

Practice location:
  • Phone: 608-251-6100
  • Fax:
Mailing address:
  • Phone: 608-963-6546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License Number17156-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: