Healthcare Provider Details

I. General information

NPI: 1750279535
Provider Name (Legal Business Name): AVINA OF MILWAUKEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9255 N 76TH ST
MILWAUKEE WI
53223-1058
US

IV. Provider business mailing address

5454 FARGO AVE
SKOKIE IL
60077-3210
US

V. Phone/Fax

Practice location:
  • Phone: 414-355-9300
  • Fax:
Mailing address:
  • Phone: 847-983-4860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: AARON TOPPER
Title or Position: MANAGER
Credential:
Phone: 847-983-4860