Provider Type Icon

GREAT LAKES NEUROSURGICAL ASSOCIATES LLC NPI 1578743019


NPI Information

NPI: 1578743019
Provider Name: GREAT LAKES NEUROSURGICAL ASSOCIATES LLC
Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
10400 75TH ST
KENOSHA, WI
ZIP 53142
Phone: (262) 948-7000
Get Directions

GREAT LAKES NEUROSURGICAL ASSOCIATES LLC is a neurological surgery in Kenosha, 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 1578743019. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10400 75TH ST
KENOSHA, WI
ZIP 53142-884
Phone: (262) 948-7000

The provider's authorized official is Yashdip S Pannu .
The authorized official title is Owner and has the following contact phone number (414) 385-8702.

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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther 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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.