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General NPI Number Information
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NPI Number | 1407751688
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Entity Type | Individual
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Provider Name | JOHN UEBELACKER
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Gender | Male
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 549 E WILSON ST
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City | MILWAUKEE
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State | WI
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Zip | 53207-1635
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Country | US
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Telephone | 414-264-2355
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Fax |
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Provider Business Mailing Address
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Address Line | N53W37134 WASHINGTON ST
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City | OCONOMOWOC
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State | WI
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Zip | 53066-3151
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Country | US
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Telephone | 262-894-1173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 54934
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1123516-30
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License Number State | WI
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