GREAT LAKES FAMILY MEDICAL CENTER INC is a clinic center in Kenosha, WI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). GREAT LAKES FAMILY MEDICAL CENTER INC NPI is 1093900136. The provider is registered as an organization entity type.
The provider's business location address is:
6123 GREEN BAY RD
SUITE 120
KENOSHA, WI
ZIP 53142-927
Phone: (262) 764-4390
Fax: (262) 764-4396
The provider's authorized official is Jawaid Quddus .
The authorized official title is President and has the following contact phone number (262) 764-4390.
The enumeration date for this NPI number is 9/12/2007 and was last updated on 8/26/2010.