MEDICARE: DR. ANNA INGSTRUP PT, 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	15393-24	WI

General Provider Information

NPI Number	:	1568037315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA INGSTRUP PT, DPT

Provider Business Mailing Address
First Line	:	7907 S 67TH ST
Second Line	:
City	:	FRANKLIN
State	:	WI
Zip	:	53132-9299
Country	:	US
Telephone Number	:	847-345-2375
Fax Number	:

Provider Business Practice Location Address
First Line	:	3620 57TH AVE STE 400
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53144-4925
Country	:	US
Telephone Number	:	262-925-5250
Fax Number	:	262-925-5251

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

Provider Enumeration Date	:	05/24/2021
Last Update Date	:	10/07/2025

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