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GREAT LAKES NEUROSURGICAL ASSOCIATES LLC NPI 1457531899


NPI Information

NPI: 1457531899
Provider Name: GREAT LAKES NEUROSURGICAL ASSOCIATES LLC
Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
8400 WASHINGTON AVE
RACINE, WI
ZIP 53406
Phone: (262) 884-4000
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GREAT LAKES NEUROSURGICAL ASSOCIATES LLC is a neurological surgery in Racine, WI. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. GREAT LAKES NEUROSURGICAL ASSOCIATES LLC NPI is 1457531899. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8400 WASHINGTON AVE
RACINE, WI
ZIP 53406-735
Phone: (262) 884-4000

The provider's authorized official is Yashdip S Pannu .
The authorized official title is Owner and has the following contact phone number (262) 321-3000.

The enumeration date for this NPI number is 11/13/2007 and was last updated on 5/17/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207T00000XNeurological SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000052140MEDICARE PINWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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