Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ketamine Milwaukee, SC

Organization Anesthesiology Physician · NPI 1871318584

Ketamine Milwaukee, SC is an Anesthesiology Physician in Milwaukee, Wisconsin. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
5

Practice location Address checks out

10424 W Bluemound Rd
Milwaukee, WI 53226-4331
Phone: (414) 206-1606
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Anesthesiology Physician Taxonomy 207L00000X
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X
Family Nurse Practitioner Taxonomy 363LF0000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1871318584
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Kane — President · (414) 206-1606
Other names Edelica
NPI enumeratedNovember 18, 2024
Last updated in NPPESNovember 18, 2024
Certification dateNovember 18, 2024
Mailing address2942 N Interlaken Dr, Oconomowoc, WI 53066-4910

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