Organization · Type 2 NPI

Great Lakes Surgery Center LLC

Ambulatory Surgical Clinic/Center · Kenosha, WI

NPI number 1700045168 Active

Practice location

6123 Green Bay Rd, Suite 100
Kenosha, WI 53142-2927

Call (262) 657-3668 Map

Mailing address

PO Box 580772
Pleasant Prairie, WI 53158-8101

Specialties and licenses

TaxonomyCodeLicense
Ambulatory Surgical Clinic/Center Primary 261QA1903XPENDING (WI)

Ambulatory Surgical Clinic/Center: Definition to come...

11 other providers at this address

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About NPI 1700045168

Great Lakes Surgery Center LLC's National Provider Identifier is 1700045168, issued on Jun 2, 2008. The primary taxonomy on file is Ambulatory Surgical Clinic/Center (261QA1903X), and the practice location is in Kenosha, WI. The record was last updated on Mar 23, 2011.