=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306719380
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARLY MILANN SADKOVICH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2025
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | S77W18690 JANESVILLE RD
-----------------------------------------------------
City | MUSKEGO
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53150-9207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 262-679-0246
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2106 MACARTHUR RD APT 14
-----------------------------------------------------
City | WAUKESHA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53188-5684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-815-7835
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 224Z00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapy Assistant
-----------------------------------------------------
License Number | 725827
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------