Healthcare Provider Details

I. General information

NPI: 1649182148
Provider Name (Legal Business Name): MS. MADISON H. UEBELACKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S 20TH ST
MILWAUKEE WI
53215-4442
US

IV. Provider business mailing address

N52W35601 W LAKE DR
OCONOMOWOC WI
53066-3204
US

V. Phone/Fax

Practice location:
  • Phone: 414-635-8400
  • Fax:
Mailing address:
  • Phone: 262-490-6351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7598-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: