Maxwell Dechant

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13578 - 24 Issued in WI

Practice address

1333 College Ave Ste B
South Milwaukee, WI 53172-1150

Phone

(414) 571-9146

Fax

(414) 571-9147

NPI assigned

Aug 1, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1932652575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 COLLEGE AVE STE B",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721150",
            "telephone_number": "414-571-9146",
            "fax_number": "414-571-9147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5434 W Capitol Dr",
            "address_2": "#101",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532162298",
            "country_code": "US",
            "telephone_number": "414-763-9520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5434 W Capitol Dr",
            "address_2": "#101",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532162298",
            "country_code": "US",
            "telephone_number": "414-763-9520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECHANT",
        "first_name": "MAXWELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13578 - 24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in South Milwaukee, WI
• Providers in South Milwaukee, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.