MEDICARE: DR. ANDREW W KANE PH.D.

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	103T00000X	Psychologist	0439	WI
2	103TA0700X	Adult Development & Aging Psychologist
3	103TB0200X	Cognitive & Behavioral Psychologist
4	103TC0700X	Clinical Psychologist	0439	WI
5	103TF0200X	Forensic Psychologist
6	103TH0100X	Health Service Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811198807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW W KANE PH.D.

Provider Business Mailing Address
First Line	:	2815 N SUMMIT AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-3439
Country	:	US
Telephone Number	:	414-964-6449
Fax Number	:	414-964-9814

Provider Business Practice Location Address
First Line	:	2815 N SUMMIT AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-3439
Country	:	US
Telephone Number	:	414-964-6449
Fax Number	:	414-964-9814

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	09/11/2025

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