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LAKESHORE PAIN AND SPINE CENTER LLC NPI 1689256539


NPI Information

NPI: 1689256539
Provider Name: LAKESHORE PAIN AND SPINE CENTER LLC

Doing Business As: LAKESHORE PAIN AND SPINE CENTER LLC

Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 52D2232686

Address:
7201 GREEN BAY RD
KENOSHA, WI
ZIP 53142
Phone: (312) 519-9936
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LAKESHORE PAIN AND SPINE CENTER LLC is a pain medicine anesthesiology in Kenosha, WI. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. LAKESHORE PAIN AND SPINE CENTER LLC NPI is 1689256539. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lakeshore Pain And Spine Center Llc.

The provider's business location address is:

7201 GREEN BAY RD
KENOSHA, WI
ZIP 53142-532
Phone: (312) 519-9936

The provider's authorized official is Bradley Silva .
The authorized official title is Owner/md and has the following contact phone number (262) 484-4035.

The CLIA number assigned to this NPI record is 52D2232686 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/21/2021 and was last updated on 8/2/2021.


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
1207LP2900XAnesthesiologyPain MedicineYes

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

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