MEDICARE: LISA A STEFL DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	11653-24	WI

General Provider Information

NPI Number	:	1104108174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A STEFL DPT

Provider Business Mailing Address
First Line	:	240 MAPLE AVE
Second Line	:
City	:	MUKWONAGO
State	:	WI
Zip	:	53149-8475
Country	:	US
Telephone Number	:	262-928-1928
Fax Number	:	262-363-1918

Provider Business Practice Location Address
First Line	:	240 MAPLE AVE
Second Line	:
City	:	MUKWONAGO
State	:	WI
Zip	:	53149-8475
Country	:	US
Telephone Number	:	262-928-1909
Fax Number	:	262-363-1918

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	01/23/2026

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