Healthcare Provider Details

I. General information

NPI: 1790692671
Provider Name (Legal Business Name): DYLAN BERSCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 W GREEN TREE RD
MILWAUKEE WI
53223-5220
US

IV. Provider business mailing address

900 S 77TH ST
WEST ALLIS WI
53214-3038
US

V. Phone/Fax

Practice location:
  • Phone: 414-393-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: