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Specialty details in registry · Burlington, WI

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At a glance

496 Mc Canna Pkwy, Burlington, WI 53105-3623

NPPES record updated Jan 6, 2026. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

496 Mc Canna Pkwy
Burlington, WI 53105-3623

Professional details: NPI, taxonomy & registry record

NPI1194682906

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 261QP2300X
Enumeration date: Jan 6, 2026
Record updated: Jan 6, 2026

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

261QP2300X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

496 Mc Canna Pkwy
Burlington, WI 53105-3623

Phone: (414) 296-6128
Fax: (888) 538-6903

Mailing address

3209 TANGLEWOOD DR

WAUKESHA, WI 531896889

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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