Healthcare Provider Details

I. General information

NPI: 1124914320
Provider Name (Legal Business Name): SOPHIE CAROLYN DRESCHER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 N 17TH ST
MILWAUKEE WI
53233-2104
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-1293
US

V. Phone/Fax

Practice location:
  • Phone: 414-288-5688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085-011728
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: