OrganizationActive
Great Lakes Foot & Ankle Centers Inc
NPI 1295941409 · Foot & Ankle Surgery Podiatrist · Kenosha, WI
Provider details
- NPI number
- 1295941409
- Entity type
- Organization
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Authorized official
- John Bostanche, Physician/Owner
- License
- 016 (IL)
Practice location
6123 Green Bay Rd
Suite 100
Kenosha, WI 53142-2927
Phone: (262) 652-3668
Fax: (262) 652-0564
Mailing address
6123 Green Bay Rd
Kenosha, WI 53142-2927
Registry dates
- Enumerated
- 2007-05-15
- Last updated
- 2021-09-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.