MEDICARE: ELIZABETH CONRATH 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	2251P0200X	Pediatric Physical Therapist	12096	WI

General Provider Information

NPI Number	:	1275135295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH CONRATH DPT

Provider Business Mailing Address
First Line	:	409 E SILVER SPRING DR
Second Line	:
City	:	WHITEFISH BAY
State	:	WI
Zip	:	53217-5226
Country	:	US
Telephone Number	:	414-888-4212
Fax Number	:	844-640-0720

Provider Business Practice Location Address
First Line	:	409 E SILVER SPRING DR
Second Line	:
City	:	WHITEFISH BAY
State	:	WI
Zip	:	53217-5226
Country	:	US
Telephone Number	:	414-888-4212
Fax Number	:	844-640-0720

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

Provider Enumeration Date	:	11/13/2020
Last Update Date	:	11/25/2025

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