Healthcare Provider Details

I. General information

NPI: 1942411152
Provider Name (Legal Business Name): PEAK PERFORMANCE SPORTS MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 N 16TH ST DEPT. OF EX. SCIENCE, CRAMER HALL 215
MILWAUKEE WI
53233-2117
US

IV. Provider business mailing address

3121 E DIANE DR
OAK CREEK WI
53154-3483
US

V. Phone/Fax

Practice location:
  • Phone: 414-852-4022
  • Fax:
Mailing address:
  • Phone: 414-852-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY SISCHO
Title or Position: OWNER
Credential: PT, LAT, DPT, CSCS
Phone: 414-852-4022